Is there any way to predict the progression of Alzheimer's? Wife was diagnosed several years ago and it has been mostly memory loss.

I was privy to a friend's journey with his wife's ALZ. He too was very adamant about caring for her by himself till the end, and God bless him for that. Once she started shadowing him constantly with her paranoia it literally drove him to drink because it ended his social life and the peace within his own home. He pulled out of this nosedive by finally hiring a competent and well-trained aid to become her companion. It was rough at the start due to her shadowing and paranoia so she fought her presence. Eventually as her ALZ progressed, she came to accept the companion which took a great burden off the husband and saved him from burnout.

My advice to you is to get help even before you think you need it. Get your wife accustomed to a good aid or 2 and make sure your own social enrichment isn't compromised. Blessings to you!

OldArkie,

I commend you for wanting to care for your wife yourself. Please take this advice I'm going to give because I'm an in-home caregiver by profession for nearly 25 years now. Most of my clients were elderly and suffering from some kind of dementia.
While she is still in rehab, ask them to send someone to your house to assess it and tell you what needs to be done to make it possible for your now handicapped wife to safely live there. Then have those renovations and equipment put in place.
Arrange for homecare services now. Please don't make the mistake in believing that you should be doing all of her care 24/7.
Your wife has Alzheimer's. DO NOT allow her to form a "shadowing" habit which means that you will have to be with her every moment 24 hours a day. Force her to be alone at times (when appropriate). Make her stay alone with hired caregivers. Go out when they are at the house no matter how much she cries or how upset she gets when you leave. Make her go to adult day care a couple of days a week whether she wants to or not. Everyone needs socialization and doing these things will help to prevent a "shadowing" habit forming. This may seem cruel to you, but it's not. It must me done.
You must also make her do for herself in whatever ways she can. Any level of independence is a positive and good thing. Even if it is small things like feeding themselves or combing their own hair, that's independence and it's important. If she can still walk, make her take her meals at the kitchen table. Do not bring it to her.
My last care client was a total invalid bedridden with LBD. She still fed herself because I insisted. If the meal was something like soup or a dish like that, I'd help her. Otherwise I made her do for herself. Yes, things got messy and I would clean them up. She was still able to get food into her mouth and able to lift a sippy-cup and drink. Friends of hers were shocked by this and couldn't believe that I wouldn't spoon-feed her or hold a baby-bottle for her to drink like an infant. I wasn't going to take that last bit of independence she still possessed away from her because seeing her eat was absolutely disgusting to witness. Be prepared for this. Be prepared for incontinence and the stubbornness over hygiene and washing up that often follows it.
Good luck to you and your wife, and I sure hope for both your sakes you take my advice here to heart.

My husband was officially diagnosed with Alzheimer’s just last fall at 72. He had been having memory issues for a couple of years that couldn’t be brushed off any more. He can still shower, dress, eat, etc. on his own and I thought I could care for him until it was physically too much for me to handle (he’s 6’4”, 230lbs.) or he began wandering which would be a safety issue. I am in my 50s & felt I could manage the situation for a long time…surely a few years. But his anxiety is off the charts. He is up off & on all night long and obsesses over various things to the point he literally breaks into a sweat and almost becomes manic. He has been on anxiety meds for years, which we are adjusting & he now has a med that seems to help his physical symptoms, but he still rattles on about whatever is bothering him. (He’s still obsessed, but not manic.) The same series of repetitive questions all day long are what work on me the most. I. AM. EXHAUSTED and think I have reached my limit mentally. Now I’m having physical symptoms from the stress. I have a good support system in friends & family and they are sympathetic, but they’re probably getting tired of listening to me vent, especially so early in the journey. I don’t want to burn THEM out listening to my woes. Each day I wake up thinking it’s a new day, I’ll do better. But I just seem to wear down quicker when he starts in with the same obsessive questions (I have written down the answers to most of his questions, but he still ASKS them.) We still have a high schooler at home & it’s affecting her as well. My best friend has worked with the elderly & dementia patients for years & told me months ago that it was time to place him. He gets extremely agitated, but not violent (yet). I’ve visited various residential facilities & I come away thinking he’s not THAT bad off to be placed yet, but something will eventually give & I fear it will be MY health. Then what? He is able to keep it together when we are out or around other people, which is a nice break for me, but it can be exhausting for him. If one could have the perfect scenario in the world of dementia, I would have thought this was it - I’m younger, fairly healthy, of strong faith, supportive friends & family, financially comfortable, excellent medical providers, willing & able to research what help is available & what I can do, etc., but it’s getting to me. I love my husband dearly & I know he can’t help it, but I will need to throw in the towel far sooner than I ever imagined for the sake of the entire household. I find myself apologizing constantly for being rude to him. I don’t believe having assistance in the home is really the answer for us, particularly because he doesn’t need physical assistance. I am still able to leave for a few hours a day if necessary. It’s noble to want to care for your wife and each situation is different, and I never expected it to be easy, but my own body is telling me it’s about time to make a change despite what my emotions are. I have read & watched everything I could find which helps me better understand the Why/How Come questions in some of this, but there is no specific roadmap especially for the What Next questions. Just prepare for the potential next steps, look into what assistance/support you can get and do whatever it is YOU have to do. It’s a hard, hard road, even when you have the best of intentions. I truly think I will be much better for him (and our daughter) when I am not the one “responsible” for him.

There is no way to predict the progression of Alzheimer', because every case is different. She probably has both, Alzheimer's and Vascular dementia combined. Depression after a stroke is common. If we add depression to her dementia, it will make everything worse. Encouragement is not going to work because she's depressed and has limited comprehension. You haven't said how old your wife is. If she is under 80, a trial with antidepressants might help her mood, but they won't improve her cognitive impairment.

I've heard that there isn't enough data in the medical literature to help clinicians and researchers understand how Alzheimer's disease progresses. Check this for more details: [url]https://alzres.biomedcentral.com/articles/10.1186/alzrt25[/url] 

if you haven’t already, research memory care homes NOW. You will need one much sooner than you think. It will be easier when the time comes if you know where you want her to go.

I would recommend Teepa Snow, a dementia expert - many videos, info & talks to be found online. Teepa uses a different progression from mild, mod, severe or that awful numbered stages one.

She also keeps the focus on CARE & what's still possible, rather than what's lost. I really like this.

But these are just guides. People are individual.

"but in 30 days, I'm on my own". Ask the rehab team to connect you to services run in the community. Don't stay alone! Completely agree with BurntCaregiver here, add & keep adding visiting health people, house cleaner, sitter, shower assist person - whatever will help. Avoid being a 'Lone Wolf' caregiver - add others to your pack.

You want “to care for her as long as her health and my ability will permit” but “in 30 days, I'm on my own”. You will be able to care for her longer if you make sure that you are NOT on your own. Like Geaton says, “ get help even before you think you need it”. Like Burnt says, “don't make the mistake in believing that you should be doing all of her care 24/7”. Getting helpers are the ‘preparations’ you should make.

Sooner or later your wife will need care from other people, whether it’s at home or in a facility. People who earlier could see the logic in all this, become more and more resistant as they get older – to ‘strangers’, to ‘homes’, to any changes at all. If your wife adjusts early it will be less stressful for her when there is no alternative. If you keep your own life reasonable, and yourself as happy as possible, it will be better for you and better for her too. Best wishes, Margaret