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My MIL lives with me and my husband. She sleeps all day... sometimes gets up between 4 and 7:00pm. We try to get up her; but, she will end up going back to bed. She can dress herself with assistance; she can feed herself.... with minor supervision - we have to tell her where to pour the milk and make sure she takes her medicine as she doesn’t know what to do with it ; and she can bathe herself - after she is finally ready. (When we tell her it is time to take a bath, my MIL suddenly become overcome with exhaustion and get back in the bed). After having her breakfast she will frequently go back to bed. Or she starts her “sundowns”. She will have an urgent need to leave the house and hail down any passing person. Or she will stand in the yard yelling for help. She frequently says that we should call the police. A few times they have arrived. She will immediately flirt with them. Her cognition abilities have definitely decreased and you cannot have a conversation with her. Also, her balance is also becoming an issue.
Thank you for any insight.

+1 Teepa Snow's info.

I never found the 'stages' 1-7 that useful. People can vary so much in the day, like you described. That's why Teepa's *gems* sum it up better for me.

Mild/mod/severe is ok when dealing with hospitals. Mild being still driving, living alone ok-ish. Severe being hardly talking or walking. Moderate being everything in-between.
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According to Alzheimers.net, here are the 7 stages of the dreadful disease:

Every person with Alzheimer’s experiences the disease differently, but people tend to experience a similar trajectory from the beginning of the illness to its end. The precise number of stages of Alzheimer’s is somewhat arbitrary. Some experts use a simple three-phase model (early, moderate and end), while others have found a granular breakdown to be a more useful aid to understanding the progression of the illness.

The most common system, developed by Dr. Barry Reisberg of New York University, breaks the progression of Alzheimer’s disease into seven stages. This framework for understanding the progression of the disease has been adopted and used by a number of healthcare providers as well as the Alzheimer’s Association.

Here is a summary of the seven stages of Alzheimer’s based on Dr. Resiberg’s system:
Stage 1: No Impairment
During this stage, Alzheimer’s is not detectable and no memory problems or other symptoms of dementia are evident.

Stage 2: Very Mild Decline
The senior may notice minor memory problems or lose things around the house, although not to the point where the memory loss can easily be distinguished from normal age-related memory loss. The person will still do well on memory tests and the disease is unlikely to be detected by loved ones or physicians.

Stage 3: Mild Decline
At this stage, the family members and friends of the senior may begin to notice cognitive problems. Performance on memory tests are affected and physicians will be able to detect impaired cognitive function.
People in stage 3 will have difficulty in many areas including:
Finding the right word during conversations
Organizing and planning
Remembering names of new acquaintances
People with stage three Alzheimer’s may also frequently lose personal possessions, including valuables.

Stage 4: Moderate Decline
In stage four of Alzheimer’s, clear-cut symptoms of the disease are apparent. People with stage four of Alzheimer’s:
Have difficulty with simple arithmetic
Have poor short-term memory (may not recall what they ate for breakfast, for example)
Inability to manage finance and pay bills
May forget details about their life histories

Stage 5: Moderately Severe Decline
During the fifth stage of Alzheimer’s, people begin to need help with many day-to-day activities. People in stage five of the disease may experience:
Difficulty dressing appropriately
Inability to recall simple details about themselves such as their own phone number
Significant confusion
On the other hand, people in stage five maintain functionality. They typically can still bathe and toilet independently. They also usually still know their family members and some detail about their personal histories, especially their childhood and youth.

Stage 6: Severe Decline
People with the sixth stage of Alzheimer’s need constant supervision and frequently require professional care. Symptoms include:
Confusion or unawareness of environment and surroundings
Inability to recognize faces except for the closest friends and relatives
Inability to remember most details of personal history
Loss of bladder and bowel control
Major personality changes and potential behavior problems
The need for assistance with activities of daily living such as toileting and bathing
Wandering

Stages 7: Very Severe Decline
Stage seven is the final stage of Alzheimer’s. Because the disease is a terminal illness, people in stage seven are nearing death. In stage seven of the disease, people lose the ability to communicate or respond to their environment. While they may still be able to utter words and phrases, they have no insight into their condition and need assistance with all activities of daily living. In the final stages of Alzheimer’s, people may lose their ability to swallow.
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Beatty Feb 12, 2020
Didn't see your post until now. No offence that 'the 7' didn't work for me - the 7 does have thorough info that will help the OP.

Who would ever get diagnosed with stage 1 or 2 though? That's what I find a bit funny/weird. (Hope I'm still a 1..)
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Try watching Teepa Snow's Early Dementia on, "you tube", for early signs of Alzheimer's. Five steps of dementia.
Positive Approach® to Care, strives to educate, support, and train others in strategies that work for dementia care.
My husband has stage three Alzheimer's. Mostly good days, but we will be moving this fall and his mood will change, until he becomes accustom to our new living arrangements. I'm fully prepared for this, being we have done this once before. As long as he knows I'm here, he seems to get over the disruption after a few stress filled weeks.
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CrushedLove18 Feb 12, 2020
Thank you very much for the info. I definitely understand about taking our loved ones out of their environment. I hope your husband will acclimate to the new place, smoothly. That must be very hard to experience ... having a spouse go through this disease.
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https://youtu.be/Eq_Er-tqPsA

This is a good video. Explains the progression of AlZ. My Mom was diagnosed with Dementia but she pretty much went thru the same stages.
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CrushedLove18 Feb 12, 2020
Okay. Thank you! I will watch this.
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Try watching Teepa Snow's Early Dementia on you tube, for early signs of Alzheimer's. Five steps of dementia.
Positive Approach® to Care, strives to educate, support, and train others in strategies that work for dementia care.
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CrushedLove18 Feb 12, 2020
Thank you! 🙂
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You can read a list of "stages" and sort of figure out where she is but I did not take much stock in the stages. My Husband was able to do things long after he should not have been able to and could not do things he should have been able to.

It sounds like your MIL would benefit from Adult Day Care. A reason to get up and get going, a routine that she can count on. A routine is very important and can help prevent some depression and anxiety. She would get more socialization and remain active longer. And you would get a break as well.
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CrushedLove18 Feb 12, 2020
Good idea. These days all she wants to do is sleep. And then when she is awake, she is anxious. A couple years ago I took her to a local group of seniors and she was higher functioning than most of them. I just would hate to set something up and then my MIL refuse to go.
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Talk to her physician about having home heath come in and do an assessment. It's possible they can provide you more information and guidance. A speech therapist might be able to provide her ways to communicate her needs better. This kind of thing is covered by Medicare as long as it's physician ordered. best wishes.
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CrushedLove18 Feb 12, 2020
Thanks. We have someone come in 3 days a week. I hadn’t thought about a speech therapist. Good idea.
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Your MIL sounds like she is in a similar stage as my mother. Fortunately, my mom is very compliant. I take her to a neurologist regularly and she feels my mom is in the late stages of dementia / Alzheimer's. Spending a lot of time sleeping is normal. Have a comfortable chair for her to nap in during the day so that she isn't always in the bed. Find simple games or activities that she may enjoy. A lot of times they have repetitive behaviors and a simple activity can keep them engaged for long periods of time. Even though my mom goes to bed on a set schedule, she is seldom in prolonged sleep. Her sleep pattern is short spans of sleep with short spans of wakefulness. I had to get over the guilt of letting her lay in bed awake. I keep her out of bed for a 6-7 hour period a day (once she get up it starts). People with dementia rarely get good sleep. When your MIL says she's tired, she probably is. Don't feel guilty about letting your MIL sleep. Don't feel guilty about giving her games meant for a 4 year old. My mom likes to fold towels (she folds a lot of clean towels). At this point, your MIL has lost the ability to reason. You're not going to persuade her to change her behavior.
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CrushedLove18 Feb 12, 2020
Yes, thank you for your insight. I have realized that my MIL does seem to be more alert when she sleeps more. I let her sleep; but, check on her ever so often. Frequently she has no interest in going out until she is ready. I have stopped trying and just stand back. My MIL also has no interest in games, puzzles, dolls, coloring, etc. I have tried, as well as our home care workers. She loves to make piles of things and “pack”. No matter what it is. Once she insisted on buttering the inside of my kitchen gloves.
Actually when I see her micro managing things; I know that her anxiety is boiling below the surface.
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CrushedLove18, I found this article that should be helpful. https://www.agingcare.com/articles/stages-of-alzheimers-disease-118964.htm

Also have Mom-in-law checked for an Urinary Tract Infection. Sometimes such an infection can mimic mild Alzheimer's/dementia. Thus if Mom-in-law does have an infection, when treated she may [or may not] calm down some of the things you are seeing. It's worth checking out.
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CrushedLove18 Feb 12, 2020
Thank you. I will look into that. Have something about that before, somewhere.
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