Understanding the 7 Stages of Alzheimer’s and Planning Ahead
Alzheimer’s is a tough road for any family, but in rural communities—where resources may be few and loved ones often live miles apart—the journey can feel especially overwhelming. Understanding the seven stages of Alzheimer’s, recognizing the signs early, and getting a head start on legal and financial planning can help. It is never too early to learn about planning options.
Stage 1: No Impairment
In the first stage, there usually aren’t any visible symptoms. Your loved one might seem completely fine. This is the best time to sit down and talk about the future—while decisions can still be made clearly. It’s wise to update or create key legal documents like a will, trust, durable power of attorney, and health care directives. An estate planning attorney can help make sure everything’s in order before memory issues begin to affect judgment.
Stage 2: Very Mild Decline
As things move into stage two, you might notice small slips—misplaced keys, forgotten names. These are often brushed off as “just getting older.” Start taking notes, documenting patterns, and attend doctor visits with someone. You can also talk with an attorney about putting safeguards in place—like adding a signer on bank accounts or protecting assets if care becomes expensive.
Stage 3: Mild Decline
By stage three, the memory lapses become more obvious. It is a struggle paying bills, keeping track of conversations, or finding the right words. Legally, this is a critical time to start Medicaid planning and seriously looking at setting up irrevocable trusts to protect assets
Stage 4: Moderate Decline
In stage four, you’ll likely see confusion about time or recent events and withdrawal from social events. Financial management declines. Automating bill payments, simplifying routines, and gently stepping in with support can help. Smart watches can provide a gentle safety net – tools like GPS tracking in case of getting disoriented, fall detection, and medications reminders.
Stage 5: Moderately Severe Decline
Stage five often brings more serious challenges—help is needed with dressing, preparing meals, or navigating the day. Caregiving can become intense. Reach out to your local Alzheimer’s Association for support ideas.
Stage 6: Severe Decline
By stage six, personality changes and confusion worsen. Wandering, agitation, and loss of recognition are common. Knowing what to expect makes it easier to plan. It may be time to consider a memory care facility. Legal efforts should shift toward getting Medicaid applications submitted and ensuring all beneficiary designations are up to date.
Stage 7: Very Severe Decline
In the final stage, your loved one may lose the ability to speak or move much. Care focuses on comfort and dignity. Hospice care—often available at home, even in rural settings—can be a huge support. This is also when families should make sure that funeral directives are clear and any remaining legal matters are wrapped up.
No matter where you live, Alzheimer’s is never easy—but planning ahead and leaning on community resources and caregiver support groups can make a big difference. Talk early, plan wisely, and don’t be afraid to ask for help. You're not alone. If you have questions about planning for a loved one with Alzheimer’s or other form of dementia, talk with one of our attorneys at (307) 682-1313.