In the middle stage, the person may have more difficulty with some everyday tasks, their memory may be more impacted, problems with perception may emerge and their ability to participate in conversations may need more support. They may also experience some changes to their mood. During the middle stage of the disease, participants may benefit from additional support in programs, especially in how you ask questions or provide instructions.
Alfred was reserved at first, and told his brother that he would not say anything, just listen before they started, but has become much more comfortable over time. He answers questions when asked, but doesn’t volunteer ideas without being prompted. Alfred’s first language is French, and sometimes his brother uses French words to help him understand. Alfred will also reply to him in French, for help with finding the right word.
Alfred sometimes takes time to find the right words, but with guided questions is able to participate. On occasion, his answers don’t completely relate to the question, but other times has great insight. Each week he loses attention around the 45-60 minute mark and wanders away when the hands-on activity starts; sometimes earlier, if distracted by other family members.
For Alfred, we remember to always pause and wait a little bit longer so that he can process his thoughts. If he seems to be having difficulty after a few moments, we can try to rephrase or simplify the question. If a comment doesn’t relate to the conversation, we try to connect something he said back to the discussion to help him reengage. We also know not to worry if he moves on from the program early.