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(originally published to Helium writing site, now gone)

At the third stage of Alzheimer’s, or the moderate stage, short-term memory becomes worse and long-term memory may also be impaired. A person might not be able to remember things they did recently. They might have problems with mental arithmetic that used to cause them no problems.

A person may forget aspects of their own background such as medical history, and might make something up to fill the gaps. They may forget their address, which school they went to, and don’t always know where they are or what day it is. Communication can be difficult. The person can’t always find the right word and doesn’t read or write much. They may repeat themselves, not finish sentences and may revert to their first language.

A person’s independence may be restricted. They may require assistance outside and at home with a range of activities. Driving, shopping, banking and paying bills might be difficult. They may still be able to eat, wash and dress, albeit with difficulty, but might not dress for the occasion or season, or might put their night clothes over the top of their day clothes.

Their appearance may change. Hygiene may become lax. Incontinence becomes common. They may take others’ things, and might not recognize themselves in the mirror. They can be restless, tap objects repetitively, wring their hands, find it hard to get comfortable on a chair, wander about chatting, and may become night-owls. They might need almost constant supervision as they may burn, injure or poison themselves.

Changes in behavior occur, such as increased irritability and aggressiveness. A person may laugh or cry for little apparent reason. Delusions occur in thirty percent of patients. It becomes hard to always know what a person wants.

Sadly, a person might not be aware of their shortcomings and inabilities, and might deny their problems. They might accuse others of making them look silly. Care is often resisted, causing difficulties for family members and for carers.

Delusions, poor communication and aggression make things harder. They can become withdrawn. Hiding objects is common. They may think their spouse is having an affair or family members are stealing from them.

Alzheimer’s is often harder on families than on the patient, as sufferers aren’t always aware of how bad things have become, and families may eventually be forced to consider long-term care solutions.