By : Lamiaa Moustafa Elbosaty
At this stage of Alzheimer's disease only fragments of memory remain. There may be emotional recognition of family, but names and relationships identification are lost. There is orientation to self only. Language is limited to short phrases and repeated words, and only simple spoken language is understood. The individual may eventually become mute and unable to communicate. There is complete dependence on others for all care, behavior manifestation disappear, although vocalization (screaming, cursing, or crying) may continue at this stage (Cotter, 2002).
Neurological changes may include Parkinsonism (slow, shuffling gait, falls, rigidity, and brady kinesis), occurrence of generalized tonic–colonic seizures, and myoclonus, weight loss, dysphagia, increased sleeping, fecal and urinary incontinence. At the end, the individual spends most of time in bed. Death is frequently attributed to complications associated with chronic debilitation, aspiration pneumonia, sepsis, urinary tract infection, pulmonary embolus or inanition (NIH, 2003).
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