Help Sheet 6

      Stages of Ability Decline & Behaviors Symptoms



      Here is a generalized list of the decline in abilities, as well as some of the behavioral symptoms


      -- Difficulty in telling a story completely.
      -- Difficulty in understanding a story or a joke.
      -- Difficulty in telling a story correctly.
      -- Loss of a train of thought in the middle of a sentence.
      -- Misuse of a word.
      -- Substituting one word for another.
      -- Losing track of money or check book balances.
      -- Misplacing belongings or losing them. -- Forgetfulness (more than normal).
      -- Inappropriate conversation.
      -- Confusion during meals.
      -- Wrong response to something said to him.
      -- Failure to recognize a familiar person or place.
      -- Confusion in unfamiliar situations.
      -- Confusion in familiar situations.
      -- Changes in manner of dress (unmatched clothing, no jacket when it is cold, etc.)
      -- Inability to find something when it is in its proper place.
      -- Taking longer that normal to Inability to complete a task.
      -- Changes in sleep pattern.
      -- Poor judgment in decision making.
      -- Unable to make a decision.
      -- Small mishaps with car (denting fender on way into garage, forgetting where car is parked). -- Accidents with car.
      -- Getting lost in car in familiar surroundings.
      -- Getting lost while walking in familiar surroundings.
      -- Unable to follow simple directions.
      -- Inappropriate mood changes.
      -- Flaccid facial appearance.
      -- Answers yes or no instead of discussing something when a question is put to him or her (can't remember the answer).
      -- Avoiding people outside the home.
      -- Sleeping more than usual.
      -- Withdrawing from activities.
      -- Wide mood swings.
      -- Poor coordination or balance.
      -- Change in appetite.
      -- Increase or decrease in sexual desires.
      -- Agitation for no apparent reason.
      -- Belligerency for no apparent reason.
      -- Inability to carry on a conversation.
      -- Repeating same statement over and over again.
      -- Disoriented as to time or place.


      Early Middle Stage

      -- Some areas of the brain are impaired, others are not.
      -- The patient begins to accept the fact that he is sick.
      -- Accepts reassurance from the caregiver.
      -- May become depressed and withdrawn.


      Middle Stage

      -- Moves from one stage to another throughout the day.
      -- The patient is unaware of making errors, most of the time.
      -- Unaware of "filling in" with sounds instead of words.
      -- Unaware of losing a train of thought.
      -- Wandering, sometimes for hours, until tired.
      -- Loss of reasoning powers.
      -- Aware only of the present (now).
      -- Unaware of what happened yesterday.
      -- Unable to plan tomorrow.
      -- Can't sit still.
      -- Unaware of surroundings.
      -- Confusion that leads to anxiety.
      -- Asks the same question repeatedly
      -- Unable to retain or process information.
      -- Loss of short-term memory
      -- Unable to hold a conversation.
      -- Knows you are talking to him, but may not be certain know who you are.
      -- A few brain pathways and personality traits remain intact.


      Middle Late

      -- Is unable to verbalize thoughts or hold a conversation.
      -- Understands much of what is said but there is a loss of comprehension.
      -- Is unable to follow a simple request.
      -- Memory loss is more noticeable. The patient will ask questions similar to "Did we have lunch yet?"
      -- Judgment is poor; poor decision making increases.
      -- Disoriented as to time; merges past with present.
      -- Disoriented as to place.
      -- Spatial orientation is poor.
      -- Coordination is poor; has a wide gait, tendency to trip.
      -- Dexterity is poor.
      -- Anxiety level is elevated; is nervous; cries easily.
      -- May be unaware, aware and/or accepting of his own errors.
      -- Has difficulty in dressing, wears wrong clothes, wears layers of clothing.
      -- Has difficulty in bathing and grooming; needs assistance.
      -- Exhibits restlessness, wandering and purposeless walking.
      -- Uses table utensils improperly.
      -- Has slight difficulty chewing and swallowing.
      -- Saves useless items. Has auditory and visual hallucinations.
      -- Easily agitated, has wide mood swings.
      -- Exhibits repetitive behavior.
      -- Has bathroom accidents occasionally.


      Late Stage

      -- Is unaware of surroundings.
      -- Does not recognize others.
      -- Is unaware of dangers and cannot be left alone.
      -- Has problems with eating and has to be fed.
      -- Is incontinent of urine and involuntary of stool.
      -- Is unable to do crafts or exercises
      -- Conversation is nil.
      -- Does not comprehend most of what you say.
      -- Has visual and auditory hallucinations.
      -- Eyes have a vacant look.
      -- Face has a flat look.
      -- Sits or lies down most of the time.
      -- Often rocks or does other repetitive motions.
      -- Coordination is poor and trips or falls easily.
      -- May refuse or is unable to walk or stand.
      -- Is not oriented to surroundings.
      -- May drool because the swallow reflex has diminished.
      -- Is unable to bathe or dress without assistance.


      Here is a generalized list of the decline in abilities, as well as some of the behavioral symptoms


      -- Difficulty in telling a story completely.
      -- Difficulty in understanding a story or a joke.
      -- Difficulty in telling a story correctly.
      -- Loss of a train of thought in the middle of a sentence.
      -- Misuse of a word.
      -- Substituting one word for another.
      -- Losing track of money or check book balances.
      -- Misplacing belongings or losing them.
      -- Forgetfulness (more than normal).
      -- Inappropriate conversation.
      -- Confusion during meals.
      -- Wrong response to something said to him.
      -- Failure to recognize a familiar person or place.
      -- Confusion in unfamiliar situations.
      -- Confusion in familiar situations.
      -- Changes in manner of dress (unmatched clothing, no jacket when it is cold, etc.)
      -- Inability to find something when it is in its proper place.
      -- Taking longer that normal to Inability to complete a task.
      -- Changes in sleep pattern.
      -- Poor judgment in decision making.
      -- Unable to make a decision.
      -- Small mishaps with car (denting fender on way into garage, forgetting where car is parked). -- Accidents with car.
      -- Getting lost in car in familiar surroundings.
      -- Getting lost while walking in familiar surroundings.
      -- Unable to follow simple directions.
      -- Inappropriate mood changes.
      -- Flaccid facial appearance.
      -- Answers yes or no instead of discussing something when a question is put to him or her (can't remember the answer).
      -- Avoiding people outside the home.
      -- Sleeping more than usual.
      -- Withdrawing from activities.
      -- Wide mood swings.
      -- Poor coordination or balance.
      -- Change in appetite.
      -- Increase or decrease in sexual desires.
      -- Agitation for no apparent reason.
      -- Belligerency for no apparent reason.
      -- Inability to carry on a conversation.
      -- Repeating same statement over and over again.
      -- Disoriented as to time or place.


      Early Middle Stage

      -- Some areas of the brain are impaired, others are not.
      -- The patient begins to accept the fact that he is sick.
      -- Accepts reassurance from the caregiver.
      -- May become depressed and withdrawn.


      Middle Stage

      -- Moves from one stage to another throughout the day.
      -- The patient is unaware of making errors, most of the time.
      -- Unaware of "filling in" with sounds instead of words.
      -- Unaware of losing a train of thought.
      -- Wandering, sometimes for hours, until tired.
      -- Loss of reasoning powers.
      -- Aware only of the present (now).
      -- Unaware of what happened yesterday.
      -- Unable to plan tomorrow.
      -- Can't sit still.
      -- Unaware of surroundings.
      -- Confusion that leads to anxiety.
      -- Asks the same question repeatedly
      -- Unable to retain or process information.
      -- Loss of short-term memory
      -- Unable to hold a conversation.
      -- Knows you are talking to him, but may not be certain know who you are.
      -- A few brain pathways and personality traits remain intact.


      Middle Late

      -- Is unable to verbalize thoughts or hold a conversation.
      -- Understands much of what is said but there is a loss of comprehension.
      -- Is unable to follow a simple request.
      -- Memory loss is more noticeable. The patient will ask questions similar to "Did we have lunch yet?"
      -- Judgment is poor; poor decision making increases.
      -- Disoriented as to time; merges past with present.
      -- Disoriented as to place.
      -- Spatial orientation is poor.
      -- Coordination is poor; has a wide gait, tendency to trip.
      -- Dexterity is poor.
      -- Anxiety level is elevated; is nervous; cries easily.
      -- May be unaware, aware and/or accepting of his own errors.
      -- Has difficulty in dressing, wears wrong clothes, wears layers of clothing.
      -- Has difficulty in bathing and grooming; needs assistance.
      -- Exhibits restlessness, wandering and purposeless walking.
      -- Uses table utensils improperly.
      -- Has slight difficulty chewing and swallowing.
      -- Saves useless items. Has auditory and visual hallucinations.
      -- Easily agitated, has wide mood swings.
      -- Exhibits repetitive behavior.
      -- Has bathroom accidents occasionally.


      Late Stage

      -- Is unaware of surroundings.
      -- Does not recognize others.
      -- Is unaware of dangers and cannot be left alone.
      -- Has problems with eating and has to be fed.
      -- Is incontinent of urine and involuntary of stool.
      -- Is unable to do crafts or exercises
      -- Conversation is nil.
      -- Does not comprehend most of what you say.
      -- Has visual and auditory hallucinations.
      -- Eyes have a vacant look.
      -- Face has a flat look.
      -- Sits or lies down most of the time.
      -- Often rocks or does other repetitive motions.
      -- Coordination is poor and trips or falls easily.
      -- May refuse or is unable to walk or stand.
      -- Is not oriented to surroundings.
      -- May drool because the swallow reflex has diminished.
      -- Is unable to bathe or dress without assistance.


      By Eileen Driscoll R.N.


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