Dementia? Me? Nah! Leave me alone!

AnosognosiaSome might call it denial, yet the actual word for this is called Anosognosia.  It is more common than you think and it happens when someone suffering from a mental illness is unaware of their condition. When someone shows signs of anosognosia, the caregiver has a very difficult time handling the situation.  It not only happens in dementia as it can also surface after a stroke or brain injury.

Although Anosognosia is hard to understand and define, researches do know that it happens due to the changes, physical and anatomical, that the brain goes through. The damage to the brain can change and affect the perception the patient has of himself and their illness and in many cases convince themselves that they are fine.  It seems that as the frontal lobes deteriorate with the advancement of the condition, anosognosia may be more common. Frontal lobes determine understanding, planning and meaning in our lives.

Being the caregiver of someone who, on top of having dementia or Alzheimer, also suffers from anosognosia can be very challenging.  If you are taking care of someone with dementia who is also anosognosic it can become truly hard when they insist they do not require any help yet you know that they do and even more so when you know that if you don’t help them they might end up hurting themselves or others.  These type of patients also refuse medical treatment and without it they might not ever come to realize that they are suffering from dementia or Alzheimer at all.

Cases of anosognosia can be complete or selective. In complete anosognosia the patient may fully ignore the fact that they are indeed suffering from dementia and may even get combative and defensive when they are confronted about their condition. Since they don’t even want to go to the doctor, anosognosia may be hard to diagnose and may be confused with plain denial.

These are the signs you should look for if you suspect your loved one is suffering not only from dementia but anosognosia as well:

  • Difficulty with daily tasks
  • Not keeping personal hygiene
  • In conversation they do not hold back inappropriate behavior
  • Defensiveness when told they are forgetful or make poor decisions.
  • Confabulation of make believe answers that they truly believe themselves. Answers may even be based on things they read or something that happened in the past.

Helping someone who does not know they have dementia?

Regardless of your loved one going through anosognosia or plain denial, the best way you can help them as a caregiver is with mitigation effects instead of attempting to make them understand they have dementia.

  • Your approach when communicating with your loved one must be gentle and empathetic. You must encourage the person at all times in all they do.
  • Come up with a schedule and try to follow it down to a T. The schedule must include tasks, your personal time, down time, etc.
  • Simplify responsibilities that are not considered necessary.
  • Be a team. Don’t do anything for them but WITH them. Offer your help and if they turn you down, keep a close watch on what they do so you can re-do it of fix it when they are not aware.
  • Do not lose your patience. Be calm and focused. Always talk to your loved one in a positive tone and a subtle way.

There are many resources online that can help you deal with everything that comes with taking care of a person with both dementia and anosognosia. You are not alone. Remember this combo is very common and that although it is extremely hard to take care of someone who suffers from it, with a little help and awareness, you will do just fine.