What Is Alzheimer's Disease?

Definition 

Alzheimer’s disease is a form of dementia that gradually impairs memory, thinking, behavior, and, eventually, daily function. 

The Importance of Early Recognition

Recognizing Alzheimer’s symptoms early allows caregivers to plan and secure support services before the disease progresses. It also eases anxiety for those affected, helping them understand what’s happening and maintain independence for as long as possible. 

Key Differences from Normal Aging

• Memory Loss—Disrupts daily life vs. occasional forgetfulness. 
• Problem Solving—Struggles with daily tasks vs. minor mistakes.
• Time & Place—Gets lost in familiar places vs. brief confusion.
• Communication—Struggles to find words vs. occasional lapses.
• Judgment—Poor decisions vs. small errors.
• Personality—Mood shifts & withdrawal vs. temporary irritability.

Watch: The 5 Questions All Families Need to Ask About Dementia. Speaker: Tam Cummings, PhD. 

Why This Guide Matters to Your Family

Empowerment Through Knowledge

This guide aims to help families dealing with Alzheimer’s feel more confident and less overwhelmed.

Proactive Planning

Anticipating future needs reduces emotional and financial stress, allowing caregivers to provide informed, compassionate care.

Actionable Strategies

This guide provides practical tools and advice to support caregivers in their daily roles, including emotional care and self-care tips.

Watch: What Is Memory? Free Education Webinar by Dr. Tam Cummings.

Back

Next

The Global Deterioration Scale (GDS)

The Global Deterioration Scale (GDS) is a reliable tool that tracks the progression of Alzheimer’s disease across seven stages of cognitive decline. It helps healthcare providers tailor their treatments and support your loved one’s healthcare needs every step along the way.

Watch: Understanding the Different Lobes of the Brain. Speaker: Dr Tam Cummings.

Stage 1: No Impairment (Preclinical Alzheimer's Disease)

What to Expect in This Stage 

• No noticeable symptoms.  
• Brain changes begin, but no memory deficits are detected. 
• Daily life remains unaffected. 

Implications for Loved Ones and Caregivers

For Loved Ones

No noticeable cognitive or functional issues. The following lifestyle changes may help delay symptom onset: 

• Take daily walks. 
• Spend time with friends.
• Eat heart-healthy, plant-based meals. 
• Get 7-8 hours of quality sleep each night. 
• Address hearing loss, if necessary. 

For Caregivers 

At this stage, your loved one is independent and not showing noticeable cognitive decline. No direct care is needed at this time

However, it may be helpful to begin learning about Alzheimer’s and available resources, so you’re prepared if and when needs change.

Assessments for Stage 1

Medical History and Physical Examination 

If your loved one has a family history of Alzheimer’s or dementia, it’s a good idea to talk with their healthcare provider. Reviewing their medical and family history can help identify potential risks and guide early screenings and preventative measures to support their long-term health.

This proactive approach helps you stay prepared as a caregiver. 

Stage 2: Very Mild Cognitive Decline

What to Expect in This Stage 

• No clinical evidence of memory deficits.  
• No significant impact on work or social activities. 
• Subtle memory lapses (e.g., forgetting familiar names, words, or the location of everyday objects).

Implications for Loved Ones and Caregivers

For Loved Ones

Cognitive decline is minimal, but your loved one may become frustrated or anxious about their minor memory lapses.

For Caregivers 

You may notice subtle but manageable memory lapses. Emotional support and reassurance are key to helping your loved one feel more at ease during this stage

Does your loved one use sticky notes to help them remember routine information? Take this quiz to find out if it’s dementia. 

Assessments for Stage 2

If your loved one is diagnosed with stage 2 Alzheimer’s, your loved one should undergo one or more of the following cognitive and neuropsychological tests to identify subtle memory changes and establish a baseline for future care. These allow you to understand the progression of Alzheimer’s and plan for your loved one’s care needs: 

• Dementia Behavioral Assessment Tool (DBAT)

  This assessment helps caregivers and family members recognize the current level of decline and the next steps required for care. 
• Mini-Mental State Examination (MMSE) 

  This 30-point questionnaire is commonly used to screen for Alzheimer’s, providing healthcare providers with an overall measure of cognitive impairment. 
• Montreal Cognitive Assessment (MoCA) 

  This simple, 10-minute screening tool is used to identify mild cognitive impairment and early dementia.

Does your loved one use sticky notes to help them remember routine information? Take this quiz to find out if it’s dementia.

Stage 3: Mild Cognitive Decline

What to Expect in This Stage 

• Some clinical evidence of a concentration deficit. 
• More significant memory issues (e.g., difficulty finding the right words, misplacing personal items, etc.). 
• Noticeable cognitive challenges that impact daily life, relationships, work, and social activities. 
• Increased withdrawal from socializing due to growing frustration and anxiety.

Implications for Loved Ones and Caregivers

For Loved Ones

You may notice increased frustration with memory lapses and a tendency to withdraw from social activities and relationships.

For Caregivers 

You may offer more support with daily tasks while also managing the emotional challenges that may arise. Start thinking about a home healthcare team to support you and your loved one.

Quiz: Is it Still Safe to Drive? 

Assessments for Stage 3

Cognitive Testing

In stage 3 Alzheimer’s, the following tests can help assess cognitive function: 

• Dementia Behavioral Assessment Tool (DBAT) 

  This assessment helps caregivers and family members recognize the current level of decline and the next steps required for care. 
• Mini-Cog 

  A quick, 3-minute screening for short-term memory and visuospatial skills. 
• Montreal Cognitive Assessment (MoCA) 

  A simple, 10-minute test to identify mild cognitive impairment and early dementia. 

Functional Assessments

The following assessments can evaluate and identify functional decline:

• Activities of Daily Living (ADLs) 

  Evaluates a person’s ability to perform everyday tasks (e.g., bathing, dressing, toileting, transferring, continence, and feeding) to determine whether assistance is needed. 
•  Instrumental Activities of Daily Living (IADL) 

  Measures a person’s ability to perform complex tasks (e.g., managing finances) and track changes over time.

Is It Still Safe to Drive?

Stage 4: Moderate Cognitive Decline (Mild Alzheimer's)

What to Expect in This Stage 

• Difficulty recalling current or recent events. 
• Confusion about time or place. 
• Noticeable memory deficits and difficulty with personal history. 
• Struggles with complex tasks (e.g., cooking or managing medication) without help.

Does your loved one have trouble finding the right words? Take this quiz to see if it’s time for memory care. 

Implications for Loved Ones and Caregivers

For Loved Ones

Completing daily tasks independently becomes harder, leading to anxiety and frustration. Maintaining personal hygiene and routine may require more help.

For Caregivers 

You will take on more responsibility at this stage, assisting with ADLs and other tasks. Emotional support is crucial as confusion and disorientation increase. Consider hiring a home healthcare team to support you and your loved one.

Note: Many caregivers experience stress and fatigue in this stage. Practicing self-care and exploring support options is highly recommended to avoid burnout. 

Assessments for Stage 4

Monitoring brain function and behavioral changes is essential for understanding your loved one’s needs. 

Behavioral and Psychological Assessments

Common Stage 4 assessments include:

• Dementia Behavioral Assessment Tool (DBAT) 

  This assessment helps caregivers and family members recognize the current level of decline and the next steps required for care. 
• Cohen-Mansfield Agitation Inventory (CMAI)  

  A 29-item questionnaire to assess agitation and mood changes.

Functional Assessments

The following assessments can evaluate and identify functional decline:

• Activities of Daily Living (ADLs) 

  Evaluates a person’s ability to perform everyday tasks (e.g., bathing, dressing, toileting, transferring, continence, and feeding) to determine whether assistance is needed. 
•  Instrumental Activities of Daily Living (IADL) 
  Measures a person’s ability to perform complex tasks (e.g., managing finances) and track changes over time.
• Neurological Evaluation 

  A comprehensive 3-part physical exam that may include:
  • Physical exam to assess motor skills, balance, coordination, reflexes, and sensory function. 
  • Cognitive assessment of your loved one’s memory, language, reasoning, and problem-solving abilities
  • Magnetic Resonance Imaging (MRI) or Positron Emission Tomography (PET) to identify possible structural abnormalities in the brain.

Does your loved one have trouble finding the right words? Take this quiz to see if it’s time for memory care.

Stage 5: Moderately Severe Cognitive Decline 

What to Expect in This Stage 

• Severe memory loss (e.g., forgetting personal history, the names or faces of close family members, or an address or telephone number of many years). 
• Significant confusion and marked decline in independence. 
• Needing regular assistance with daily living tasks like dressing, preparing meals, and bathing. 
• Noticeable emotional changes (e.g., paranoia or delusions). 

Implications for Loved Ones and Caregivers

For Loved Ones

As memory loss progresses, your loved one may struggle to recognize family members or remember personal history, leading to confusion, frustration, and anxiety.

For Caregivers 

You will need to offer ongoing assistance with daily tasks, but your loved one may resist, requiring frequent Alzheimer’s care plan adjustments. This can be emotionally taxing, so remember to prioritize self-care and seek additional support when needed.

Assessments for Stage 5

At this stage, you and your loved one will likely have an Alzheimer’s care team in place. They may recommend one or more of the following: 

• Dementia Behavioral Assessment Tool (DBAT) 

  This assessment helps caregivers and family members recognize the current level of decline and the next steps required for care.
• Neurological and Imaging Studies 

  This may include CT/MRI and PET scans to evaluate structural brain changes.
• Laboratory Tests 

  Blood work to check for underlying medical conditions (e.g., thyroid disorders or vitamin deficiencies).
• Psychiatric Evaluation  

  This evaluation helps you and your loved one’s care team manage mood or behavioral disturbances over time.

Watch: Communication Tips in Dementia Care Presented by Dr. Tam Cummings.

Stage 6: Severe Cognitive Decline (Moderate Alzheimer's) 

What to Expect and Impact on Life

Cognitive Impairment 

• Severe memory loss, especially of recent events and personal information. 
• Loss of awareness of surroundings (e.g., time, place, and identity). 
• Decreased ability to communicate. 

Functional Impairment 

• Struggles with daily activities (e.g., bathing, dressing, eating).
• Requiring help with toileting and incontinence.
• Inability to travel independently (e.g., walking, taking the bus, etc.).

Behavioral Changes 

• Increased agitation, restlessness, and wandering. 
• Delusions, paranoia, and hallucinations. 
• Marked personality changes (e.g., apathy, withdrawal, or aggression). 

Implications for Loved Ones and Caregivers

For Loved Ones

Your loved one may no longer recognize family members and struggle with basic motor skills like walking or eating.

For Caregivers 

Providing 24/7 care is crucial at this stage. The emotional and physical demands can be overwhelming as you manage severe symptoms, which may include aggression or agitation. Your loved one may now need specialized Alzheimer’s care from an experienced team of certified dementia providers within a compassionate, assisted living memory care community.

Comprehensive Assessments at Stage 6

At this stage, several assessments are commonly used to understand your loved one’s needs and to guide care planning: 

• Dementia Behavioral Assessment Tool (DBAT) 

  This assessment helps caregivers and family members recognize the current level of decline and the next steps required for care. 
• Functional Assessments 

  These evaluate your loved one’s ability to perform daily activities and their increasing dependence on caregivers.
• Informant-Based Questionnaires 

  Caregiver tools like The Eight-Item Informant Interview to Differentiate Aging and Dementia (AD8®) are used to assess memory, orientation, judgment, and functional changes (from your perspective), identifying shifts in behavior or ability.
• Psychiatric Evaluation  

  A psychiatric evaluation help manage depression and other emotional challenges that may arise, ensuring your loved one’s emotional well-being is addressed. 

Watch: Free Dementia Webinar: What Does That Behavior Mean? Presented by Dr. Tam Cummings.

Stage 7: Very Severe Cognitive Decline (End-Stage Alzheimer's) 

What to Expect and End-Stage Symptoms 

Physical Symptoms

• Inability to control body movements. 
• Inability to walk, sit, or hold up head without assistance. 
• Rigid muscles, abnormal reflexes, and an inability to swallow. 
• Inability to control bladder or bowel movements. 
• Limited ability to respond to the environment or recognize loved ones. 

Care Needs 

• Require daily assistance with personal care tasks. 
• Require 24/7 care for help with walking, sitting, and swallowing. 
• Vulnerable to infections, like pneumonia. 
• Pressure sores may develop when sitting or lying in one position for prolonged periods. 

Implications for Loved Ones and Caregivers 

For Loved Ones

At this stage, your loved one will require 24/7 supervision, either in-home or at a residential memory care community. They may be unable to communicate or recognize others, and all daily activities will need assistance.

For Caregivers 

As a family caregiver, you will face deeply emotional challenges, including making end-of-life decisions about advanced medical interventions. The emotional strain can be overwhelming, which is why finding the right support team for you and your loved one is essential.

Watch: Supporting End-of-Life Care

Final Stages of Assessment 

• Dementia Behavioral Assessment Tool (DBAT) 

  This assessment helps caregivers and family members recognize the current level of decline and the next steps required for care. 
• Actively Dying Assessment Tool (ADAT) 

  This assessment allows caregivers and family to track and recognize the signs and stages of the final part of life.  
• Continued Functional Assessments  

  Ongoing evaluations will help you and your care team plan for your loved one’s changing needs, ensuring that Alzheimer’s care is provided with compassion and dignity. 
• Behavioral and Psychological Assessments
  These care assessments will help address late-stage behavioral challenges and ensure appropriate emotional and psychological support is available. 
• Preparing for End-of-Life Care and Advanced Medical Evaluations 

  This stage will prioritize your loved one’s comfort and well-being, help guide decisions, and ensure your loved one receives the most appropriate care in their final stages. 

Back

Next

Key Warning Signs That Indicate Increased Care Needs

Safety Risks

• Forgetting to turn off appliances. 
• Wandering away from home or getting lost in familiar places. 
• Medication errors (e.g., taking the wrong medication, missing doses, etc.).
• Difficulty following directions or staying on task with specialized activities.
• Leaving doors or windows open, creating an unsafe environment.
• Repeatedly forgetting to lock doors or secure valuables.
• Difficulty recognizing potential trip or fall hazards.
• Increased vulnerability to financial exploitation due to impaired judgment or trust.

Decline in Self-Care

• Neglecting or poor personal hygiene. 
• Severe or unintentional changes in weight. 
• Choosing inappropriate clothing for the weather or season. 
• Forgetting to take medications or attend medical appointments.
• Difficulty managing household chores (e.g., laundry, cleaning, etc.).
• Failure to maintain a daily routine or healthy habits.

Increased Dependency 

• Struggling with daily living tasks (e.g., dressing, bathing, feeding).
• Needing help with meal preparation, cooking, or eating.
• Dependence on others for transportation or travel.
• Difficulty managing finances.
• Difficulty navigating familiar surroundings or remembering the way home.
• Requiring frequent reminders to complete routine care tasks (e.g., brushing teeth, taking medications, etc.).

Caregiver Burnout: It's OK to Seek Help

Signs of Burnout 

• Physical and emotional exhaustion. 
• Restlessness and difficulty sleeping. 
• Increased frustration and irritability with your loved one. 
• Heightened worry about future unknowns. 
• Feelings of hopelessness, helplessness, or loss of interest in activities or hobbies. 
• Neglect of personal health. 
• Social withdrawal from friends and family. 
• Decreased focus and concentration. 

When Is it Time to Make a Move to Memory Care?

Considering a Transition to Memory Care

When Is it Time for Memory Care?  

If your loved one is experiencing significant memory loss that disrupts daily life or if caregiving has become overwhelming, it may be time to consider professional memory care services. 


Signs of significant memory loss may include: 

• Confusion.
• Disorientation.
• Unsafe behaviors.
• Difficulty performing basic self-care tasks independently.
• Wandering.
• Frequent repetitive questions.
• Inability to manage medications.

Read: When Is it Time to Make a Move to Memory Care? 

When Is it Time for Memory Care?  

Planning for your loved one’s memory care needs allows you to explore care communities, understand your options, and make informed decisions without the pressure of a crisis. 

Touring communities and having early conversations help ensure a smoother transition when the time comes, and high-quality, compassionate, and dignified care for your loved one.  

Learn More: Empowering Your Decision: A Guide to Touring a Memory Care Community 

Open Communication 

How to Discuss Care Options With Your Loved One 

Talking about memory care with your loved one can be difficult, but open conversations can help them feel heard, respected, and supported. 

Depending on how far their Alzheimer’s has progressed, monitor their body language, and if they appear anxious or agitated, gently change the subject. These conversations are best to have in stages 2-3, when they can still help plan their future. 

At Anthem Memory Care, our compassionate staff takes the time to truly know each resident—their likes, dislikes, and interests—honoring who they are and who they once were. Our Pathways of Purpose philosophy focuses on building meaningful connections to enhance your loved one’s health and well-being. 

Find an Anthem Memory Care community near you to explore our services. 

Back

Next

Empowering Your Decision: A Guide to Touring a Memory Care Community

In-Home Care 

Pros

A familiar environment and personalized routines can provide stability and ongoing comfort to your loved one.

Cons

Caregiver burnout, necessary home safety modifications (and associated costs) can create emotional and financial burdens for caregivers and their families.

Memory Care Communities

Anthem Memory Care provides a safe, compassionate environment with 24/7 supervision, specialized activities, and a trained staff who genuinely understand each resident’s unique needs. Our Pathways of Purpose program focuses on enhancing your loved one’s well-being through life-enriching activities like music, therapy, pet visits, reducing family caregiver burden, and offering compassionate and dignified respite care when needed. 

Find an Anthem Memory Care community near you to explore our services. 

Benefits of Memory Care 

Anthem’s Memory Care communities offer social interaction, professional care, and the support that family caregivers need, ensuring your loved one’s dignity and happiness are prioritized.

Survey: Can I Afford Memory Care? 

Can I Afford Memory Care?

Hospice and End-of-Life Care 

When To Consider Hospice

If your loved one is experiencing a loss of communication, difficulty swallowing, or a significant decline in quality of life, it may be time to explore hospice care. While Anthem Memory Care does not provide hospice services directly, we partner with trusted hospice providers to ensure compassionate support during this difficult stage. These providers focus on pain management, emotional well-being, and helping your loved one remain as comfortable and dignified as possible.

Back

Next

The Emotional Toll of Caregiving 

Caregiving is an act of deep love, but it often comes with its own set of emotional challenges: guilt, stress, anxiety, grief, and isolation. The weight of those feelings can sometimes feel overwhelming, especially when you’re concerned about what the future will bring. 

What many caregivers don’t realize is how caregiving can negatively impact your health. Chronic stress can weaken your immune system, increase your risk of anxiety and depression, and take a toll on your overall well-being. 

Taking care of yourself isn’t selfish. It’s necessary. Practicing self-care ensures you can keep offering the love and care your loved one needs.  

Self-Care Strategies for Caregivers 

Physical Well-Being 

• Aim for 7-8 hours of sleep each night. 
• Move your body daily, even if it’s a short walk. 
• Eat healthy, balanced meals.
• Keep up with your own health needs.

Emotional and Mental Health

• Acknowledge your feelings.
• Ask for help when needed.
• Take breaks and practice mindfulness.
• Stay connected with loved ones and caregiver support groups.
• Consider therapy or counseling.

Emotional and Mental Health

• Acknowledge your feelings.
• Ask for help when needed.
• Take breaks and practice mindfulness.
• Stay connected with loved ones and caregiver support groups.
• Consider therapy or counseling.

Building a Support Network 

When Is it Time for Memory Care?  

It’s always okay to ask for help.

• Join local and online Alzheimer's Support Groups. 
• Hire temporary respite care for much-needed relief.
• Consider therapy and counseling to support your mental wellness. 

Watch: Compassion Fatigue and Caregiver Stress What Every Caregiver Needs to Know by Dr. Tam Cummings 

Back

Next

Download a Personalized Care Plan to track your loved one’s Alzheimer’s care needs and have critical information at your fingertips in case of an emergency. 

Download the PDF Workbook Now

Back

Next

Discussing End-of-Life Wishes 

We understand discussing end-of-life wishes is very difficult, but it can help make things much easier when the time comes. Respecting your loved one’s wishes ensures their care aligns with their values and honors their dignity. 

Legal and Financial Planning for Alzheimer’s 

Long-Term Care Insurance 

Exploring long-term care insurance options can offer peace of mind as you navigate the future. These policies can provide financial support for non-medical care services for your loved one. 

Advance Directives 

Advance directives, like a Living Will and Healthcare Proxy, help ensure your loved one’s healthcare wishes are respected when they can no longer advocate for themselves.

Power of Attorney

Having a Power of Attorney allows you or someone you trust to make crucial decisions for your loved one, especially in times of need. 

Get started with this easy, step-by-step guide: Alzheimer’s Association—Plan for Your Future

Back

Next

Get started with this easy, step-by-step guide to plan for your future.

National Organizations 

• Alzheimer's Association 
• National Institute on Aging 

National Organizations 

Anthem Memory Care:

• Family Resources

Local Alzheimer's Support Groups and Agencies 

Arkansas

• Alzheimer’s Arkansas
• Alzheimer’s Association—Arkansas Chapter

California

• Alzheimer’s Association—Northern California Chapter
• Alzheimer’s Los Angeles
• Alzheimer’s Orange County

Colorado

• Alzheimer’s Association—Colorado Chapter
• Colorado Respite Coalition

Illinois

• Alzheimer’s Association—Illinois Chapter
• Illinois Department on Aging—Alzheimer’s Disease Assistance

Kansas

• Alzheimer’s Association—Central and Western Kansas Chapter
• Kansas Department for Aging and Disability Services—Kansas Caregivers

Minnesota

• Alzheimer’s Association—Minnesota-North Dakota Chapter
• ACT on Alzheimer’s

Ohio

• Alzheimer’s Association—Central Ohio Chapter
• Alzheimer’s Association—Cleveland Area Chapter
• Alzheimer’s Association—Greater Cincinnati Chapter
• Alzheimer’s Association—Greater East Ohio Area Chapter
• Alzheimer’s Association—Miami Valley Chapter
• Alzheimer’s Association—Northwest Ohio Chapter
• Ohio Department of Aging—Caregiver Support 

Tennessee

• Alzheimer’s Association—Tennessee Chapter
• Alzheimer’s Tennessee

Wisconsin

• Alzheimer’s Association—Wisconsin Chapter
• Wisconsin Department of Health Services—Dementia Care

Back

Next

Caring for someone with Alzheimer’s can feel overwhelming, and that’s okay. At Anthem Memory Care, we are here to support you with personalized, compassionate care that honors your loved one’s dignity and unique story.  

Our dedicated teams take the time to truly understand your loved one—their history, interests, and preferences—ensuring they feel engaged and valued every day. Our expert memory care programs provide more than just high-quality Alzheimer’s care. They provide peace of mind for you and your family. 

Let’s take the next step together: 

• Download your FREE Personalized Care Plan template. 
• Explore Anthem Memory Care communities near you. 
• Contact us today to learn how we can help. 

Back