the person may confuse words, get frustrated or angry, and act in unexpected ways, such as refusing to bathe. Damage to nerve cells in the brain can also make it difficult for the person to express thoughts and perform routine tasks without assistance. SYMPTOMS, WHICH VARY FROM PERSON TO PERSON, MAY INCLUDE: Being forgetful of events or personal history. Feeling moody or withdrawn, especially in socially or mentally challenging situations. Being unable to recall information about themselves like their address or telephone number, and the high school or college they attended. Experiencing confusion about where they are or what day it is. Requiring help choosing proper clothing for the season or the occasion. Having trouble controlling their bladder and bowels. Experiencing changes in sleep patterns, such as sleeping during the day and becoming restless at night. Showing an increased tendency to wander and become lost. Demonstrating personality and behavioral changes, including suspiciousness and delusions or compulsive, repetitive behavior like hand-wringing or tissue shredding. In the middle stage, the person living with Alzheimer’s can still participate in daily activities with assistance. It’s important to find out what the person can still do or find ways to simplify tasks. As the need for more intensive care increases, caregivers may want to consider respite care or an adult day center so they can have a temporary break from caregiving while the person living with Alzheimer’s continues to receive care in a safe environment. LATE-STAGE ALZHEIMER'S (SEVERE) In the final stage of the disease, dementia symptoms are severe. Individuals lose the ability to respond to their environment, to carry on a conversation and, eventually, to control movement. They may still say words or phrases, but communicating pain becomes difficult. As memory and cognitive skills continue to worsen, significant personality changes may take place and individuals need extensive care. At this stage, individuals may: Require around-the-clock assistance with daily personal care. Lose awareness of recent experiences as well as of their surroundings. Experience changes in physical abilities, including walking, sitting and, eventually, swallowing Have difficulty communicating. Become vulnerable to infections, especially pneumonia. The person living with Alzheimer’s may not be able to initiate engagement as much during the late stage, but he or she can still benefit from interaction in ways that are appropriate, like listening to relaxing music or receiving reassurance through gentle touch. During this stage, caregivers may want to use support services, such as hospice care, which focus on providing comfort and dignity at the end of life. Hospice can be of great benefit to people in the final stages of Alzheimer’s and other dementias and their families. To learn more about the stages of Alzheimer’s disease and find resources to help care for your loved one, visit alz.org or call 800-272-3900. ALZHEIMER
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