Alzheimers middle stage, also known as the moderate stage, can last anywhere from 2 to 10 years. This is where the disease really begins to affect everyday life. At this point you can no longer hide the illness. Keep in mind everyone is different. Your family member may have a few of the behaviors or all of the behaviors. Either way, the more you learn and understand about Alzheimers middle stage the easier it will be for you.
Communication skills are affected in several ways. They may have difficulty finding the right words and understanding what is said to them. Often they begin repeating or they may use wrong words because they are unable to remember the correct word. Reading and writing also becomes increasingly difficult
Behaviors will begin to surface. This can be very disturbing to family members. Their personality can change. I have seen quiet passive people become very loud and aggressive. I have also taken care of people who were very religious their entire life and the disease will turn them into cussers that would make a sailor blush. They may also become paranoid and suspicious. Repetitive movements may surface, such as pacing or touching a certain object over and over. Inappropriate sexual behaviors may also be exhibited in this stage.
Poor judgement is inevitable and leads to safety issues. Stoves may be left on, water left running, tools used inappropriately, medicine taken, strange items in appliances, or they may begin to wander. Wandering is one of the biggest safety concerns with Alzheimers middle stage. They may go outside for some unknown reason and get lost. We have all seen on the news at some point in time when some confused person is missing. This is usually someone in the middle stage of Alzheimers.
Hygiene often becomes an issue. They will forget to bathe or will have difficulty bathing themselves. They will also need help with their clothing. Dressing themselves will become very difficult and they will need coaxing and prompting to put their own clothes on. They usually lose all initiative towards self hygiene.
Toileting becomes increasingly difficult. They will begin to have "accidents". The medical world refers to this as incontinence. Eventually they will reach the point when they are completely unaware of their "accidents".
Sleep disturbance often arises in this stage. Many people in this stage experience insomnia. They may stay awake all night long. I have seen patients go for several days without sleep. This is very difficult for the caregivers. Especially if they are the only one providing the care. Other people with Alzheimers middle stage sleep most of the time. This varies greatly with each person.
This is the stage when you begin to realize you need help at times. The middle stage is very difficult emotionally for family members. The stress of dealing with all of the behaviors can be overwhelming. You will need a support system in place to help you through this stage. There are many places to turn to for support, see my caregiver burnout page for suggestions.
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