How can you tell when your loved one has entered the next stage of Alzheimer's?

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Every little thing I notice my husband doing, I am asking myself is his illness getting worse? How will I tell? Also, the neuro suggested he do word puzzles and the such every day...I can't get him interested in doing anything other than working in the yard or doing dishes. I am grateful he is active, but I want to try to help him keep as much cognitive function for as long as possible. We are early on in this process and I don't want to become a nag. Any suggestions?

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1) It really isn't critical to know what stage the disease is in. If he is in stage 4 now (as best you can tell) and he is progressing you can think of him in stage 4/5, if that helps to have a label.
2) Physical activity is also excellent for dementia. Working in the yard and doing dishes is awesome.
3) Did he ever do Sudoku puzzles? There is a wooden board with colored balls based on that puzzle. (I think it is called ColorKu or something like that.) On a bad day my husband couldn't do this at all. On a good day he was pretty good at it when we played it together. He couldn't play it at all alone, but that was OK -- it was something fun we could do together. (Neither of us had done Sudoku.) That kind of game is mentally stimulating. I think you might try finding a game or puzzles that might interest your husband. How about cards? How about watching an "educational" video? My husband loved nature shows, especially about animals. If his brain is taking in new information, that is stimulating.
4) Try not to become a nag. There are so many things we have to encourage or insist that our spouses with dementia do -- take their pills, do their exercises, get regular sleep and meals, maintain their hygiene, etc. It is easy to fall into the role of rule enforcer. If you can find a mentally stimulating activity that he likes, great! But try not to let it become one more thing to insist on or to stress over.

The spouse of a person with dementia has a really challenging role to play -- and it is not one we signed up for or had training to do. Cherish the good moments. Do the best you can with the challenges.

A caregiver support group can be really helpful. Experience is a great teacher, and lots of people sharing their experiences speeds the process along.
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