What are the most difficult stages of Alzheimer's and what are the symptoms that indicate reaching it? Alzheimer's disease is a neuropathy that negatively affects brain cells, that is, it is among the types of dementia. It leads to many problems related to thinking, behavior, and memory, and it develops slowly. The disease goes through many different stages, but detecting it early helps control it and slow down the deterioration, as there is not yet a final treatment to cure Alzheimer's, but the quality of life of patients can be greatly improved.

What are the most difficult stages of Alzheimer's? 

Alzheimer's disease goes through many different stages, starting from the mild stage in which the patient faces difficulty in thinking, making plans, organizing and managing things, in addition to taking a long time to work on solving his problems or completing daily tasks, even routine ones, but at this stage he does not face any problem related to recognizing people and places. As for the most difficult stages of Alzheimer's and the last stage, the symptoms of dementia are very severe, and the patient suffers from a total loss of memory in addition to the difficulty of managing and knowing what surrounds him. Not only that, but he becomes unable to communicate verbally with those around him and only uses some 

Symptoms of the most difficult stages of Alzheimer's

How do the most difficult stages of Alzheimer's develop?

Alzheimer's disease goes through several stages that gradually develop until it reaches its most difficult cases. At each stage, the symptoms worsen and have a deeper impact on the affected person's ability to lead his daily life. These stages can be explained in detail as follows:

• The first stage: It begins with the appearance of simple symptoms similar to the normal forgetfulness associated with aging. The affected person suffers from forgetting some details, such as the names of people, where things are placed, or the dates of daily appointments. Those around him may also notice difficulty concentrating or making easy decisions, but he is still able to rely on himself in normal daily activities.
• The second stage: Witnesses a greater deterioration in memory, as the affected person becomes unable to remember recent events or the names of close people, and begins to forget details of his daily life, such as when to take medications or arrange activities. He may also feel confused in familiar places, face difficulty in managing his financial affairs or dealing with complex tasks, and appear clear changes in behavior such as irritability, anxiety, or social isolation.
• The third stage: It is more severe, as the injured person loses the ability to remember basic information such as his name, the names of his family members, or the details of his personal life, and his motor and cognitive skills become so weak that he may be unable to get dressed, eat his food, or go to the bathroom on his own. His language skills also deteriorate significantly, so he loses the ability to speak or understand speech, and he exhibits unusual behaviors such as motor or verbal repetition. He also suffers from sleep disturbances and spends a long time wandering around aimlessly.
• The fourth stage: It is the most difficult, represented by the complete deterioration of physical and mental functions, as the patient becomes completely unable to move, sit, or communicate. He loses the ability to eat or swallow normally and becomes exposed to serious health complications such as respiratory or urinary system infections or skin ulcers resulting from continuous lying down. His immunity is greatly weakened, which increases the possibility of infection, and his condition may gradually deteriorate until he reaches death as a result of these complications.

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The best methods for treating the most difficult stages of Alzheimer's

In the advanced stages of Alzheimer's disease, it is difficult to stop mental and physical deterioration completely, but comprehensive medical and humanitarian care can be provided that helps alleviate the symptoms and improve the patient's life as much as possible. Treatment methods at this stage focus on support and care more than drug treatment because the loss of mental and physical functions is significant, and the best treatment methods include the following:

• Specialized daily medical care: At this stage, the patient needs careful health follow-up by a medical team that includes a doctor specializing in neurology or geriatrics and nurses with experience in caring for the elderly. This care includes monitoring vital signs and controlling any chronic diseases such as blood pressure or diabetes, as well as monitoring nutrition, excretion, and sleep.
• Use of ancillary medications: The doctor may prescribe some medications that help relieve behavioral symptoms such as anxiety, agitation, or depression. He may also use pain relievers if the patient suffers from physical illnesses that cause him severe discomfort. The medications must be administered very carefully to avoid drug interactions or strong side effects that may negatively affect his health.
• Proper nutrition: It is considered one of the most important aspects of caring for an Alzheimer’s patient in its advanced stages because the affected person loses the ability to eat by himself or forgets to chew and swallow, and may need pureed food or nutritious liquids that are easy to swallow, and hydration must be constantly monitored to avoid dehydration, which may lead to serious complications.
• Physical and occupational therapy: Physical therapy helps move the body and prevent ulcers resulting from long sleep in bed. It also works to strengthen weak muscles and improve blood circulation. As for occupational therapy, it may be used to stimulate the senses, or provide simple activities that suit the patient’s abilities and maintain partial communication with the surrounding environment.
• Psychological care and emotional support: An Alzheimer’s patient in advanced stages needs the presence of people with whom he feels safe and psychologically comfortable. Therefore, care must be based on patience and tenderness and avoid shouting, reprimanding, or putting psychological pressure on him, because his condition does not allow him to respond normally. It is advised to repeat words gently and reassure him continuously.
• Dealing with sleep disorders: Many patients at this stage suffer from disturbed sleep or wandering at night. Non-pharmacological means can be used first, such as calming the surrounding atmosphere, reducing the lighting, or playing calm music. If they do not succeed, light sleeping medications can be used with the doctor’s supervision.
• Prevention of health complications: The patient must be protected from infections, especially lung or urinary tract infections, through constant hygiene, turning the body at least every two hours to avoid skin ulcers, and monitoring any signs of temperature or change in the color of urine or breathing to take the necessary measures quickly.
• Family and caregiver support: Family members and caregivers need continuous training and guidance from specialized doctors so that they can deal with the patient in a proper manner, and they must receive sufficient rest periods to avoid physical and psychological exhaustion because long-term care is very stressful.

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Who are the people most at risk of developing the most difficult stages of Alzheimer's?

Alzheimer's disease does not affect everyone in the same way or speed. There are certain groups that are more vulnerable to reaching its advanced and difficult stages due to a group of genetic, health, environmental and stereotypical factors. Below is a breakdown of the most important people who are considered more susceptible to the most difficult stages of Alzheimer's:

• People of advanced age, as aging is considered one of the most important risk factors. The older a person is, the greater the probability of developing Alzheimer’s, specifically after the age of sixty-five. The percentage is much higher after the age of eighty-five due to the decline in normal brain functions with age.
• People who have a family history of the disease, as the chances of infection increase if one of the parents or siblings has been afflicted with Alzheimer's, which indicates the presence of a special genetic predisposition that may be transmitted across generations, especially in the case of the presence of certain genetic mutations such as the APOE4 gene, which is associated with an increased probability of infection and faster development of the disease.
• People with uncontrolled chronic diseases such as high blood pressure, diabetes, high cholesterol, or excessive obesity, as these diseases affect the health of blood vessels and thus affect blood flow to the brain, which accelerates the deterioration of nerve cells and increases the risk of developing advanced stages of Alzheimer’s.
• People who suffer from heart problems or have had strokes because these conditions affect the blood vessels in the brain and cause the death of some nerve cells, making the brain more fragile and more susceptible to rapid development in the stages of Alzheimer’s.
• People who suffer from an unhealthy lifestyle, such as lack of physical activity, lack of exercise, poor nutrition, and lack of intake of fruits, vegetables, and foods rich in antioxidants, as these factors lead to poor brain function and accelerate cognitive decline.

Frequently asked questions

When does an Alzheimer's patient lose the ability to speak?

An Alzheimer's patient loses the ability to speak after reaching the most difficult stages of Alzheimer's, which is the last stage in which severe cognitive deterioration occurs and with it the loss of the ability to respond to the environment and people around him, in addition to the loss of the ability to speak. 

What are the signs of an Alzheimer's patient dying?

Alzheimer's disease may lead to death in some advanced cases, especially with advancing age and the occurrence of chronic diseases and various geriatric diseases, but the period of deterioration varies. Some sufferers may live with it for a year or two and may sometimes reach twenty years, but there are some signs that indicate severe deterioration such as delusions, hallucinations, loss of the ability to walk, weakness and extreme weakness, in addition to failure of internal organs. 

How do I make an Alzheimer's patient eat?

An Alzheimer's patient may have difficulty eating food and may strongly refuse to eat it, so you should provide him with small meals throughout the day instead of one meal. Give him food in the form of fingers that he can hold. You should prepare his favorite foods and provide high-calorie snacks such as protein-rich yogurt and other foods that give him energy. Let him eat slowly and remind him that he must chew food well. Beware of force-feeding him and try to encourage him and be gentle with him. 

Thus, we have provided a comprehensive answer about what are the most difficult stages of Alzheimer’s and we have learned about the various stages that accompany this disease, in addition to learning a lot of information about the development of Alzheimer’s disease, but you must always be in contact with the specialist doctor in order to monitor the patient’s behavior and work to develop a treatment plan that protects against rapid deterioration of the condition and works to improve the patient’s quality of life. We, within Al-Mousa Hospital, have the best team of doctors specialized in treating Alzheimer’s and we have many successful cases who were able to live well. 

Sources 

The 3 Stages of Alzheimer’s: What To Expect and What To Do – butler

What Are the Stages of Alzheimer’s Disease? – healthline