This is the 4th post of this blog.   If you missed some, on my computer it tells how many posts are on the blog, and then lists the posts, so you can access them.  And sometimes when I click on it, all the posts pop up.  I am going to start this post by listing the 7 stages of Alzheimer's and commenting on them.  There is also a "mini-mental state exam" (MMSE) test that they give him every time we visit the neurologist.  The perfect score on that is 30, and Bob started out at about 28 six years ago.  The score is supposed to go down 2-4 points a year but it hasn't necessarily followed that pattern.  He did very well for the first five years after the diagnosis.  But this past year he has declined very rapidly and the test scores bear that out.  It was 14 at the visit in May, down from 22 the year before.  The doctor was so surprised by the significant drop that he ordered a CT scan, which was unchanged from the first one he ever did.  He saw him a month later, and that day he scored 18, which really perplexed the doctor.  I told the doctor, "I told you he had good days and bad days!"
Back to the 7 stages of Alzheimer's:
1.  No impairment.  The neurologist at this point called it MCI (also the call letters for the KC airport!) or Mild Cognitive Impairment.  He said it could go on to Alzheimer's or might never progress.
2.  Very mild decline.  At this point I could see a progression.
3.  Mild decline--difficulty in finding the right word in conversation, or difficulty in remembering people's names, which never happened before--either of them!
4.  Moderate decline.  In this stage they have poor short term memory (but NOT long term memory!)
They are supposed to have trouble with simple arithmetic, but it is so weird, Bob has never been good at math, and he couldn't answer the question on the MMSE test about what season it was, but could count backwards from 100 by 7s with hardly any trouble!
5.  Moderately severe.  There is significant confusion (he can't even tell you which sport team he is watching).  There is difficulty dressing appropriately (he had on a polo shirt and a tie the other day) but they can stall bathe and toilet independently.  I was having trouble getting him to shower about a year ago.  I mentioned it to the Alzheimer's Association social worker, and she said Alzheimer's patients usually don't like to shower.  Their brain already feels scrambled and the water hitting their head intensifies the feeling.  So we switched to baths, and he is doing well with that.  I think he is currently in this stage.
6.  Severe decline.  The person is unaware of their surroundings, wanders, and has loss of bowel and bladder control.  He has not started wandering yet, but I just got bracelets for both of us--mine has "caregiver" on it and his has "Alzheimer's) with the emergency phone numbers.  Since I can still leave him, the social worker pointed out that what if I have a car accident or something and died, no one would know that there was a dependent person at home.
7.  Very severe.  They are near death.  They may lose their ability to swallow, and in my experience, they choke easily and can develop pneumonia if they aspirate.  A lot of times the cause of death is listed on the death certificate as pneumonia, when it should have been Alzheimer's, which is probably why the number of patients recorded as dying of Alzheimer's is inaccurate.
I know I said I would talk about things we had tried to slow the progress in this blog, but it is already too long, so I will do that next time!