T:Questions re: late stages of AD	
Q:This is my first time posting. 
 My father in law is <age> and he wasDiagnosed about <time_period> ago with AD. 
 He has beenProgressing quickly and as of lately he has really gone Down hill. 
 He has been in and out of rehab <num> timesDue to pressure wounds. 
 (He hasnt been able to walkDue to hip/feet/leg issues) he has also been in the <institution><num> due to surgery for his pressure wounds. 
  He was living in an <institution> buthe can not go back bc he needs a higher level of care. 
  Being that his routine has been changing and he's beenIn and out of different places he seems very confused,  morethan normal. 
 He does not eat on his own anymore, he pockets his food so he is on a purée diet. 
 He reallyCan not do anything at all on his own. 
 He doesn't speak much and when he does he whispers. 
 He also sleeps a lot. 
  As if recent he is not interested in anything at all such as theTV ( he used to want it on even though he didn't follow it) healso hardly speaks to us. 
 Instead he has just been staring at usWith an angry look on his face. 
 He only has our family,  which isMyself,  his son and our <num> children. 
 Other familyMembers have chosen to not be part of his life or help withAnything for that matter. 
 If has been a big struggle asHe is financially dependent on us for some time now. 
  My question is ; does this seem like late stages and whatIs the average progression at this point. 
 He sometimes knowsOur names but lately it seems he maynot. 
 He was seeing a <professional_practitioner> but beingThat he is bed bound and it's been very hard to move him we haven't been able to see the <professional_practitioner> in about <time_period>. 
 Any help,  advise would be greatly appreciated. 
  	A:Thanks <name>. 
 I appreciate that. 
 It's a huge burden andbreaks our hearts to see him this way. 
 I feel for anyone going through this as it is so awful. 
 I will certainly look for a support to call as I have many questions. 
 Thanks again. 
  


A:In the last,  or <num>rd stage of Alzheimers,  the pt is seldom able to talk at all,  or constantly repeats the same thing. 
 They may be physically healthy for quite awhile. 
 many just keep walking and walking and walking. 
 Generally forget how to feed themselves. 
 Hallucinations may be common. 
 They do not recognize even the closest relatives. 
 and trying to 'reason' with them brings nothing but frustration to everyone involved. 
 They are usually incontinent. 
 Some are combatitive. 
 Many succumb to pneumonia,  which thank all that is holy,  the <professional_practitioner> will NOT treat aggressively. 
 They become like zombies if they continue to live. 
  This is what I believe with all my heart. 
 I truly believe that when they are in that stage that their soul no longer inhabits their bodies and that they are blessedly free,  in a peaceful dimension (whatever you call it) and that their bodies simply operate in brain-memory robot like behavior. 
 Please know that regardless of what it looks like. 
 it is MUCH worse for the loved ones during the <num>nd and <num>rd stages. 
 and that the soul of the one with Alz is truly free and at peace. 
 I truly hope I have not hurt or offended anyone by writing this. 
 I only want it to help. 
 I worked with Alz pts and know what it did to families. 
  Sending you all love and understanding. 
  <name>


A:Hello . 
 I understand that there is a difference between alzheimers and dementia,  but I believe many of the differences are usually small. 
 My Mother passed away in <date> - from Dementia. 
 She was officially diagnosed with dementia about <time_period> ago while in the <institution> after falling down. 
 Undoubtedly,  it began much earlier. 
 She was,  for <time_period>,  back into her own home but with a <professional_practitioner> required 24/7 <professional_caregiver>. 
 Then,  her last <time_period> were in an <institution> for Dementia and Parkinsons - a terrific specialized <institution>. 
 And that was a requirement by the <institution> <professional_practitioner> after one of her major evening hallucinations put her into the <institution>. 
 I feel for your partial family to have to deal with all the forms of support for your father-in-law. 
 It isn't fair . 
 and it IS harder on the supporting people than on the patient - at least in my belief!  In my Mothers case,  she had money put away,  so that it was not a financial burden on me - although by the end,  her money was close to running out. 
 For moral support,  it was just me . 
 and at times,  one of my daughters. 
 But the other daughter washed her hands and continues to wash her hands of helping anyone - unless there's something in it for her. 
 Toward the end,  many of the reactions of my Mother were very similar to what you're saying about your FIL. 
 The staff,  at one point in <date>,  suggested that I bring in <institution> for her. 
 That organization was terrific. 
 They were caring. 
 They did not get into the way of either the <institution> staff or the primary <professional_practitioner>. 
 They kept me informed - as often as I wished. 
 And the purpose was to make her final days as pleasant and pain-free as possible. 
 The <institution> was paid for by medicare. 
 The duration of <institution> can be almost anything. 
 In my Mothers case,  it was close to <time_period>. 
 It can be much longer though often is not. 
 I don't know that anyone could tell you if your FIL is nearing the end. 
 I think it's safe to say he is in the later stages though. 
 In my Mothers case,  the AL staff was very careful NOT to give any kind of timeframe for her. 
 But,  when <institution> is suggested - it's getting close. 
 <institution> called me three times the day my Mother passed - to keep me informed - and to let me know that her time was very close. 
 Swallowing food does often become very difficult. 
 It was for her - and that often leads to difficult breathing and/or pneumonia at the end. 
 I wish you and yours peace. 
  <name> & <name>
