Stages of Ability Decline & Behaviors Symptoms
By Eileen Driscoll R.N.



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-- May become depressed and withdrawn.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, butmay 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.



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