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Managing Relationships Through the Stages of Alzheimer’s Disease

“Because Alzheimer’s disease and other forms of dementia are progressive in nature, a loved one with the disease will undergo many physical and emotional changes,” says Steve Carney, Wellness Director Administrator of Impressions Memory Care at Bryn Mawr, located in Bryn Mawr, PA.

“These changes, in turn, will cause potential issues in the person’s relationships with their spouse, other family and friends. The greatest relationship changes are usually felt by the person’s spouse who is suddenly transformed from partner to caregiver. For them, this change in relationship becomes the new normal.

“Therefore, to plan and prepare for the changing relationship occasioned by Alzheimer’s, it is important to gain an understanding of the specific characteristics of each unique stage of the disease.”

The Three Stages of Alzheimer’s that Affect Relationships

The Mayo Clinic® and the Alzheimer's Association® explain that Alzheimer's disease progresses slowly through three basic stages. These are defined as mild (early stage), moderate (middle stage), and severe (late stage).

As a result of the physical, mental and emotional changes experienced in each stage, there will also be inevitable changes in the relationships between family members, friends and the individual with Alzheimer’s.

  1. Mild Alzheimer's disease (early stage) – During the early stages of Alzheimer's, a person may still drive, work and be part of social activities. Despite this, the person may feel as if he or she is having memory lapses, such as forgetting familiar words or the location of everyday objects. Friends, family or neighbors begin to notice difficulties, and changes in relationships will begin to occur. During a detailed medical interview, doctors may be able to detect problems in memory or concentration.
  2. Moderate Alzheimer's disease (middle stage) – Typically, moderate Alzheimer's is the longest stage and can last for many years. As the disease progresses, the person with Alzheimer's will require a greater level of care. You may notice the person with Alzheimer's confusing words, getting frustrated or angry, or acting in unexpected ways, such as refusing to bathe. Damage to nerve cells in the brain can make it difficult to express thoughts and perform routine tasks. There are significant changes in relationships at this stage, as the person’s symptoms become increasingly challenging.
  3. Severe Alzheimer's disease (late stage) – In the final stage of Alzheimer’s, individuals lose their ability to respond to the surrounding environment, to carry on a conversation and, eventually, to control movement. They may still say words or phrases, but communicating feelings of pain becomes difficult. Personality changes may take place and they need increased help with daily activities and require more extensive care.

These physical changes through the stages typically result in major changes to longstanding family and spousal relationships, including role reversals that can be uncomfortable and stressful. For example, a husband who now must pay the bills and balance the checkbook or a wife who now needs to manage the maintenance and upkeep of the home and property. Sexual relations also decline as a result of Alzheimer’s progressive effects. 

Adult children can also be impacted by having to assume legal, financial and healthcare decisions for a parent with Alzheimer’s – essentially becoming the parent of their parent. 

Relationship Tips for Spouses, Family and Friends

The Alzheimer’s Association® provides a variety of useful suggestions for spouses and others in maintaining a productive relationship with the person living with Alzheimer’s for as long as possible as they move through the three stages. For example:

  • Continue participating in as many activities as you can with your spouse or loved one – Adapt activities as needed to make them comfortable and enjoyable.
  • Find new activities that you can do together – Continue doing things you have always enjoyed doing together and try new activities that can maintain your relationship like walking or sitting together in a favorite outdoor location.
  • Talk with your loved one about how you can help and support them now – Also discuss what they can still do on their own.
  • Work with your loved one to identify and organize information you may need later regarding caregiver services and costs – Organize documents you may need into a file. When considering future services, include housekeeping and respite (caregiver relief) care. Start your search for local services, resources and programs by using the Alzheimer’s Association’s® online Community Resource Finder.
  • Discuss any role changes in the relationship with a professional counselor or clergy member – Include changes in your sexual feelings or ways of connecting intimately.
  • Attend early-stage and/or caregiver support groups through your local Alzheimer's Association® chapter – Sometimes befriending another couple in the same situation offers new possibilities for supportive relationships.
  • Connect with others – You and your spouse/partner can connect with others on our online message boards, ALZConnected. Also, stay connected with family and friends.
  • Identify the emotional needs of young children in the family – Try to allay their fears and talk to them about what their loved one is experiencing, emphasizing that they cannot help how they are acting.
  •  Communicate honestly to friends, coworkers and neighbors about your loved one’s condition – Encourage them to continue their normal relationship with your loved one to the extent still possible

“Although the progressive effects of Alzheimer’s cannot be stopped,” says Steve, “Following these expert tips can help you to have a meaningful relationship with your loved one for as long as possible.”

We Would Love to Hear from You! 

If you have comments or questions about our blog on Alzheimer’s and changing relationships through its stages, we’d love to hear from you. We also encourage you to share any of your caregiving experiences in our comments section.

Engaging Days. Meaningful Moments.

Loved ones with Alzheimer’s disease or other memory impairments require specialized care and support. They also deserve a lifestyle rich in dignity and fulfillment. Impressions Memory Care at Bryn Mawr provides residents with Engaging Days and Meaningful Moments that emphasize individual abilities, encourage socialization and promote the highest level of independence possible. We offer a complete continuum of leading-edge programs, services and amenities that address the total physical, emotional and social needs of residents in a caring setting that offers individual suites with large private baths and the comforts of home. Our community touches hearts and changes lives. 

Helping Families Be “Family” Again 

Memory loss caused by Alzheimer’s disease, dementia or another form of memory impairment doesn’t only affect the person who has it – it affects the entire family.

If you have a loved one with early- to mid-stage memory loss, you know how challenging it can be to provide the care that’s needed while trying to maintain balance in your life. As care needs increase, you may not be able to meet them physically or emotionally. It’s often difficult to be available to care for your loved one’s health and well-being around the clock.

If and when the time comes to seek additional help, place your trust in Impressions Memory Care at Bryn Mawr. We lift the stresses and worries of being a caregiver from your shoulders, enabling you and your family to enjoy time with your loved one again. 

For more information, please call Sharon at (484) 380-5400 or contact us online.

Disclaimer: The articles and tip sheets on this website are offered by Impressions Memory Care at Bryn Mawr and Main Line Senior Care Alliance for general informational and educational purposes and do not constitute legal or medical advice. For legal or medical advice, please contact your attorney or physician.