Dear Attorney Tully:

I feel like a bomb shell has been dropped on me.  My husband, who is only 65 years old, has been diagnosed with early onset Alzheimer’s.  I don’t know what I should do, who I should turn to and what we need to do next.  I’m frightened about our future, and I don’t know what to expect.  Please point me in the right direction.

ANSWER: When your loved one is diagnosed with Alzheimer’s, you are faced with many different issues:  How do you handle your loved one’s legal and financial affairs when he can no longer do so?  How can you provide care for your loved one without neglecting other family members or your job?    There is help in the community and there are steps you should take in the early stages.

• You should research the different services available. 
• Discuss options and your husband’s specific wishes for support, including home care, alternative living situations, and adult day care.
• Find out what local resources are available to you.
• Learn about qualification for and benefits of Medicaid and whether Medicaid will be an option in your situation.
• Contact an Alzheimer’s planning attorney to make sure appropriate estate planning is in place, sign a financial power of attorney and a health care representative form and learn how to qualify for Medicaid benefits.  It is extremely important this be done as early as possible, before the ability to make decisions is lost.

Finally, it is important that you understand the stages of Alzheimer’s disease.  No two cases of Alzheimer’s are ever alike, but researchers have been able to identify certain patterns in the progression of the disease.  These are known as the seven stages of Alzheimer’s disease.  There is no established length of time for any of the stages, since each individual case progresses at a different pace.

Stage 1:  This stage may last for several years.  It is characterized by the destruction of nerve cells and accumulation of plaque.  There is usually no outward sign the disease is taking hold.

Stage 2:  Slight memory loss begins to occur.   An individual may struggle to remember names, recall events or find items, such as car keys or bills.  It is not uncommon for sadness, depression or anxiety to set in.

Stage 3:  Memory loss is more pronounced and begins to interfere with work and home life.  An individual in this stage may find it hard to recall the names of everyday objects, run even short errands or retain anything they read.  Following recipes or balancing a checkbook may also be difficult.  These symptoms often lead to frustration, anxiety, and denial for both the individual with Alzheimer’s and their loved ones so people in this stage often begin to withdraw from social situations.

Stage 4:  Memory loss becomes even more pronounced in this stage.  Appointments are quickly forgotten as are current events or family activities.  Watch for a change in sleeping habits, wandering, anger, paranoia or depression.

Stage 5:  The individual needs assistance with activities of daily living, such as cooking, picking out clothes and grooming.  They may be unable to recall phone numbers, addresses or the name of people they do not see frequently.  

Stage 6:  Help will be needed with even the most basic activities – bathing, eating and using the bathroom.  Individuals in this stage also have trouble remembering any recent events or the name of their loved ones although events in the distant past may still be quite vivid.  Delusional thinking and paranoia often set in, sometimes leading to violent behavior.  The individual may sleep more often and withdraw, while talking less and less frequently.

Stage 7:  Individuals in this stage are usually bedridden, incontinent, and incapable of feeding themselves, speaking or communicating in all but the most rudimentary of ways.