As Alzheimer’s progresses, patients display little memory and are unable to process new information. Furthermore, they may not remember knowing a person, lose track of time, and have impaired recent memory.
At this stage in the disease, the person is easily disoriented and gets lost in familiar places, which can last for hours. Patients exhibit wandering behavior.
Confabulation is the creation of plausible stories in place of actual memories to maintain self-esteem. Alzheimer’s patients can display confabulation to providers and family members when describing their actions. Typically, family members relate to the health care provider what actually occurred and clarify any confabulated story by the patient.
Perseveration describes the repetition of phrases and behaviors. This is very common among patients with advanced Alzheimer’s. They may continue to focus on a particular question repeatedly or continue to repeat a gesture or task. This is because they don’t remember asking or doing the task.
These patients no longer have an ability to think abstractly. They cannot organize or plan accordingly, and find it difficult to draw conclusions and solve problems.
In the final stage of Alzheimer’s, the patient loses the ability to respond to the environment, carry on a conversation and may lose the ability to smile (mask-like facies). Major behavioral changes also coincide with the cognitive decline - being compulsive, having repetitive behavior, needing help with eating and using the toilet.
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