Often the person and caregiver do not realize there is a health problem at this point. They may feel that fatigue, extra stress, fickleness, stubbornness or laziness are causing the problems.

• Memory Loss: The elder may begin to have problems recalling daily events, while long-term memory remains intact. S/he may repeat questions or recent comments, get lost in conversations and misplace things;
• Disorientation: There is often a decline in the sense of direction. The elder may get lost in a familiar neighborhood or be unable to follow directions to the store. There may be a decline in the sense of time, such as being unable to remember appointments or the actual date;
• Apraxia: The elder may forget how to use a tool or find it difficult to use tools or equipment, such as appliances, a toothbrush or eating utensils;
• Anomia: The person may forget the right word or name of a person. The words may feel at the tip of the tongue, but the speaker is not able to say them;
• Personality Changes: The person may seem different. S/he may be more withdrawn, frustrated, irritable, mellow, sensitive or inconsiderate of others;
• Trouble With Routines: There is less ability to keep up with the daily routine at work or at home. S/he may forget what bills have been paid, or be able to handle office finances or telephone calls. At home, they may find it difficult to use a checkbook or prepare meals;
• Decline in Grooming: There is a decline in grooming or personal hygiene. A previously well-groomed person may be untidy, unbathed or have uncombed hair.

Communication

Closely related words are substituted for forgotten words. When you can’t make out what a person with Alzheimer’s Disease needs, point to the objects in question while asking questions like: "Do you want your purse? Your comb?" The person will have trouble understanding and following directions. Keep your sentences short and your directions clear. "Mother, fold the scarf." "Put the scarf in the drawer." "Close the drawer."

1. Discuss important business during the morning when everyone is fresh;
2. Focus on one topic at a time;
3. Use specific words, names of people and objects;
4. Do not use pronouns or general language;
5. Words or events may be forgotten. Don’t take it personally if birthdays or other special events are forgotten.

Behavioral Problems

Behavioral problems often occur early in the disease, before a caregiver is even aware that the person is afflicted. For instance, the person may become easily angered when a mistake is made due to memory loss. One person may lash out verbally at the caregiver when it is pointed out that she forgot to pay a bill. Another may become very angry when he asks why a favorite relative hasn’t visited lately and is told she was just there the day before.