Hello everyone,

I first want to say I have been quite busy and have not stopped in here lately...so please accept my apologies. I do come and read for time to time...but now its my turn for a question. I got a call from the ALF that my Father is in and they told me they think its time for depends full time. It seems my Dad has begun to have more frequent accidents, even during the day time when he is reminded to 'go'. Is this the sign that I have been dreading that we are now moving into Stage 7? Most of what I have read is that when both urniary and fecal incontinence occurs regularly that is the sign that Stage 7 is here.

What has been everyones experience with this? When my Nana (Dad's mom) was 79...dad's age, she was still living on her own, with assistance, was not incontinent at all (that didn't come until she was around 86 or so...and she died at age 92). Is this a sign that it is moving faster with my Dad? I know we can't predict the path nor the speed of this disease...but my logical mind is looking for signs, symptoms and answers that can't be found...so I come here seeking any of your wisdom and guidance you care to share.

Thank you in advance,
Anita

I am so sorry Anita. I have about "0" experience wit this. Mom is still contnent, well, most the time. We had an incident, at a restaurant, when she started having a coughing fit, she said she peed down to her knees, poor thing, but that frankly, it could have been...me!?!

I am certain others will be along shortly, and give you all of their sage advice. The stages are just guidelines as you know, but there could be another reason for this, so doesn't mean this is a done deal.

Anita,

Incontinence is one of the symptoms that we see in stage seven, but that doesn't mean that your dad is going to start showing all the stage seven symptoms over night.
Bill was incontinent for over a year maybe closer to two years.

I agree with Joyce. This could go on for a long time. Helen was incontinent for about 9 months before she started showing any other signs of Stage 7. Actually she was only incontinent as far as urine goes but was fecally continent up until the day she died.

So just breathe sweetie and try not to panic. This disease just sucks, doesn't it?

Stage 1:


No impairment (normal function)




Unimpaired individuals experience no memory problems and none are evident to a health care professional during a medical interview.



Stage 2:


Very mild cognitive decline (may be normal age-related changes or earliest signs of Alzheimer's disease)




Individuals may feel as if they have memory lapses, especially in forgetting familiar words or names or the location of keys, eyeglasses or other everyday objects. But these problems are not evident during a medical examination or apparent to friends, family or co-workers.



Stage 3:


Mild cognitive decline
Early-stage Alzheimer's can be diagnosed in some, but not all, individuals with these symptoms




Friends, family or co-workers begin to notice deficiencies. Problems with memory or concentration may be measurable in clinical testing or discernible during a detailed medical interview. Common difficulties include:



Word- or name-finding problems noticeable to family or close associates


Decreased ability to remember names when introduced to new people


Performance issues in social or work settings noticeable to family, friends or co-workers


Reading a passage and retaining little material


Losing or misplacing a valuable object


Decline in ability to plan or organize



Stage 4:


Moderate cognitive decline
(Mild or early-stage Alzheimer's disease)




At this stage, a careful medical interview detects clear-cut deficiencies in the following areas:



Decreased knowledge of recent occasions or current events


Impaired ability to perform challenging mental arithmetic-for example, to count backward from 75 by 7s


Decreased capacity to perform complex tasks, such as planning dinner for guests, paying bills and managing finances


Reduced memory of personal history


The affected individual may seem subdued and withdrawn, especially in socially or mentally challenging situations



Stage 5:


Moderately severe cognitive decline
(Moderate or mid-stage Alzheimer's disease)




Major gaps in memory and deficits in cognitive function emerge. Some assistance with day-to-day activities becomes essential. At this stage, individuals may:



Be unable during a medical interview to recall such important details as their current address, their telephone number or the name of the college or high school from which they graduated


Become confused about where they are or about the date, day of the week or season


Have trouble with less challenging mental arithmetic; for example, counting backward from 40 by 4s or from 20 by 2s


Need help choosing proper clothing for the season or the occasion


Usually retain substantial knowledge about themselves and know their own name and the names of their spouse or children


Usually require no assistance with eating or using the toilet



Stage 6:


Severe cognitive decline
(Moderately severe or mid-stage Alzheimer's disease)




Memory difficulties continue to worsen, significant personality changes may emerge and affected individuals need extensive help with customary daily activities. At this stage, individuals may:



Lose most awareness of recent experiences and events as well as of their surroundings


Recollect their personal history imperfectly, although they generally recall their own name


Occasionally forget the name of their spouse or primary caregiver but generally can distinguish familiar from unfamiliar faces


Need help getting dressed properly; without supervision, may make such errors as putting pajamas over daytime clothes or shoes on wrong feet


Experience disruption of their normal sleep/waking cycle


Need help with handling details of toileting (flushing toilet, wiping and disposing of tissue properly)


Have increasing episodes of urinary or fecal incontinence


Experience significant personality changes and behavioral symptoms, including suspiciousness and delusions (for example, believing that their caregiver is an impostor); hallucinations (seeing or hearing things that are not really there); or compulsive, repetitive behaviors such as hand-wringing or tissue shredding


Tend to wander and become lost



Stage 7:


Very severe cognitive decline
(Severe or late-stage Alzheimer's disease)




This is the final stage of the disease when individuals lose the ability to respond to their environment, the ability to speak and, ultimately, the ability to control movement.



Frequently individuals lose their capacity for recognizable speech, although words or phrases may occasionally be uttered


Individuals need help with eating and toileting and there is general incontinence of urine


Individuals lose the ability to walk without assistance, then the ability to sit without support, the ability to smile, and the ability to hold their head up. Reflexes become abnormal and muscles grow rigid. Swallowing is impaired.[list]

My mom lost bladder continence starting in about 2005....first at night then during the day. She was mostly bowel continent while she was mobile. Just in the last few months, since about Thanksgiving, did she lose the ability to walk and I'm assuming that since she was wheelchair bound was also bowel incontinent. Stage 7 took me by surprise, in fact, it wasn't until I read Snick's stages again that I realized she had been in Stage 7. But the signs of that, in retrospect, were more of the lack of walking, ability to hold herself upright, needing help with feeding (and anybody who remembers my posts from a few years ago will know that Mom ATE), loss of speech, and not able to smile. I also realize now that the stages are blurred and some things listed in one stage may happen earlier than expected...or later.

Thank you everyone for your replies! I had my Dad and Uncle Bill (Dad's brother) for Easter Dinner. It was a really nice day...Dad didn't have his glasses of course, but he was happy! He ate 2 plates of food, desert, even a small glass of wine! He was not in depends that day, and he did use my bathroom...wo who knows how this will go. The only thing I noticed this time was that he is more unsteady on his feet, other than that he talked, answered questions well, sat and petted my 2 Beagles, and all in all had a great day. I guess the important thing is just to continue to live in the moment, thoroughly enjoy the good days, and just make it through the bad ones.

Thank you one and all for all your support...this is quite a place to be!

Anita

Anita, I'm so glad you had a good Easter with your dad. It's so easy to project into the future with this disease since we all know where it leads. I just hope you can have more of these days where you can just live for the moment. Don't miss out on these good days.

I can't help on this-mom never was incontinent until the very last-she was still using the bathroom the week before she went into the coma.

Just remember the stages are a general rule-each person is different and their progress through each stage can be very different from others.

Pat

Anita,

Things seemed to always be changing. I tried to never think about what might happen in the future as things progressed, but I was ready when they did because by coming here I knew it was coming.
I guess it's like being in school. You go to class everyday and know there will be a test eventually, but you don't worry about that test everyday. You just want to be prepared when it comes.

I'm glad you had a good Easter with Dad and your uncle.

Hi Everyone,

Thanks again for all your responses! Things with Dad seem to be up and down. In one of my last posts I talked how we had a good Easter...2 weeks later when I visited he harly talked, and just had this vacant look on his face. When I said 'Hi Dad' he didn't even register that I was there, let alone he was being spoken to. I left kind of depressed (to say the least) and was dreading how he would be the next time I visited. Friday I went and his face just lit up...with this huge smile and a hug and kiss for me when I got there. He was very talkative (although none of it made sense of course) and I just listened and commented with general questions, ones he could answer to. We had lunch then went out for a drive and ice cream at Friendly's.

So, still I guess we are just taking one day/moment at a time and some days are good and some are not...

Hope everyone has a great Holiday Weekend!

Anita

Enjoy those good days Anita. I hope you have a lot more of them

Anita,

I started Mom wearing Depends about 6 months ago. Most times she makes it to the bathroom, but she was having too many accidents so I was able to fool her into wearing Depends just telling her they were a new kind of underwear with a built in pad, and she wouldn't have to change her slacks as often if she wore these. It actually went quite easy. She's at an early stage 6, although at times I think she's at a 4 or 5. Its so darned confusing.

But I agree that with this disease, you just never know what stage they are in just because of a different happening. It is a day by day thing. I know there's days where I think mom has progressed to another stage, and then one day she wakes up and its like she progressed back to the lesser stage. Its so confusing. But take the good days and hope for as many as you can get. It seems like they do get less and less. I'm glad you got a chance to take him out and have a nice day with him. Those are the days that are so nice to remember.

Hope everything is still going well. Update us when you can.

jackie