How can I identify the third stage of Alzheimer's disease?
The severe stage of Alzheimer's disease is one which the individual now has to rely fully on someone else to care for them. Typically this is somebody that has now crossed over that threshold, which a caregiver was previously helping out with; their care at their home or an assisted living facility. This individual now starts actually, showing more behavorial problems. They might wander at night, they might get into inappropriate activities in the middle of the night trying to get dressed thinking it's already the daytime, or become more combative because they don't recognize who the individual is before them. They might forget for example, who a relative or a close acquaintance is, maybe just asking who are you and becoming more suspicious. Delusional, or psychotic symptoms are more common place with the individual occasionally hallucenating, or having false beliefs that other people are trying to harm that individual. You might also see the overlap of some aggitated behavior, again in response to the cues that the individual sees environmentally. The severe staging unfortunately is probably the worst, because that individual's has lost most capabilities to fend for themselves. And so now, someone else is literally having that individual eat, bathing them, dressing them, toileting them, and so on. Fortunately, the end stage does not last as long as the middle stage. We typically quantify this staging through a tool that'll be called the full-steam mini-mental status exam. The MMSE, although it's a crude tool, is user friendly. You can pretty much divide it into a thirty point scale. So anyone that's scoring more than twenty points is considered mild, twenty to ten points would be the individual that's typically staged in the moderate staging, and anything less than ten would be considered severe staging based on that particular tool.
