Long-Term Care

The three stages of Alzheimer’s disease

LTC Nursing Assistant Trainer, June 23, 2005

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Alzheimer's disease (AD) is a degenerative condition of the nervous system that involves tangles in the fibers of the brain. There are three stages to AD. Stage one begins with the onset of the disease and continues until AD is diagnosed. This stage usually lasts two to four years. Stage two is the longest stage, usually lasting two to 10 years. Stage three is the final stage, ending in death.

A large number of AD patients ends up in nursing homes. Although your residents will already be diagnosed, it's important for you to recognize the signs of the stage of AD they are in. The following are the signs and symptoms of each of the three stages of AD:

Stage one

  • Memory loss of recent events
  • Difficulty performing familiar tasks
  • Problems with language
  • Disorientation as to time and place
  • Poor judgment
  • Confusion about directions
  • Inability to handle money
  • Problems with abstract thinking
  • Misplacing things
  • Changes in personality, mood, or behavior
  • Loss of interest in usual activities

Stage two

  • Increasing memory loss and confusion, including difficulty recognizing friends and family members
  • Decreasing attention span
  • Restlessness and wandering
  • Making repetitive statements
  • Making up stories to explain strange actions
  • Developing behaviors, such as suspicion, irritability, and frustration
  • Difficulty reading and working with numbers

Stage three

  • Incontinence
  • Inability to recognize family members or self in a mirror
  • Weight loss
  • Inability to care for self
  • Long periods of sleep
  • Inability to communicate with words



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