What is Anosognosia in Dementia?
Anosognosia is a medical term that means “without knowledge of disease”. When anosognosia occurs, it limits one’s ability to have insight on what they are capable of doing.
It is a neurological problem that damages parts of the brain that impact memory, general thinking skills, emotions and physical abilities. As a result, a person with anosognosia and dementia may not be able to recognise their mental health condition and how it affects them.
Symptoms of anosognosia may vary significantly from person to person, and its severity can change over time, even fluctuating within a day. So a person with anosognosia may understand what is happening, while other times they may be unaware that there’s something wrong. Also, they may occasionally show difficulty with language skills, but may create a logic that blames on their forgetfulness or fatigue, rather than their medical condition. Reminding these individuals with their cognitive impairment may induce anger and the person with anosognosia may become defensive.
Anosognosia is not the same as denial
Having anosognosia and being in denial are very different. When someone denies their dementia, they are aware of their problem, yet refuse to accept it. However, with anosognosia, the damage dementia causes in their brain makes it impossible for that person to be aware of their condition.
It is important to recognise challenges anosognosia brings on an individual with dementia. Understanding this can help caregivers and family members learn how to help their loved one.
To help you get started, here are 6 ways to help when someone has anosognosia in dementia:
1. Stop convincing them they have dementia
If you are using evidence to explain and insist that someone has dementia, it is not going to help the individual. In fact, it will only irritate them and lead them to a false belief that you are wrong.
A more effective strategy that will help the individual is to make subtle changes around them and ensure a safe living style. Also, when talking with them to address your concern, use a calm tone of voice and speak positively as much as possible.
2. Work with doctors and care team
As your senior’s dementia symptoms increasingly become more difficult to handle, you can consider receiving help from professionals such as doctors, psychologists and home visit support workers.
When receiving help, let the care team know the cognitive limitations the senior has, and that convincing them with logic is not effective. Discuss and work collaboratively with the care team to ensure your older adult receives the appropriate support necessary for their living.
3. Make a safe living environment
It is easy for seniors with anosognosia and dementia to overlook their limited abilities, jeopardising safety for themselves and others. This could be trying to drive, manage money, cook, or walk outside alone despite not knowing their way back.
When reacting to these situations, you need to be creative and work out ways to ensure the senior’s safety. For example, you can pretend to have lost the car keys, work together to prevent problems with finance, give simple cooking tasks for the elder to do, or take a walk together. Allow the older adult to exercise their independence while you, as a caregiver, observe for safety.
4. Avoid correction and confrontation
People with dementia live in their own reality, meaning they experience a different version of the reality due to their brain damage. Their brain is not able to process information properly, which leads them to confusion, anxiety, fear and anger in the person. This is why trying to speak logic to them is often ineffective.
Dementia care experts advise carers to step into the dementia individual’s reality, rather than correcting them. Try to solve problems discreetly and avoid conflict as much as possible.
5. Offer solutions positively and subtly
The less your senior feels limited for reasons they don’t understand, the less agitated they would be. Therefore, it is important to be creative and offer solutions in a positive way to people with anosognosia.
One of the ways you can try is offering a compromise with a positive incentive. For example, if the elder does not wish to stay active, you could say, “How about we clean the house together? We’ll be done twice as fast and have plenty of time to watch your favourite show!”
6. Learn more about dementia
There are many dementia care and communication techniques you can use that are proven to be effective. With appropriate techniques in place, you can avoid any frustration and stress that may occur between you and your senior.
Here are some helpful resources to help you get started:
- Alzheimer’s Association
- Alzheimer’s Foundation of America
- 3 Stages of Dementia: What to Expect
- 12 Best Alzheimer’s and Dementia Books for Caregivers
- 14 Caregiver Support Groups on Facebook You’ll Want to Join
At Living Waters Aged Care, we provide compassionate and personalised care for all our clients.
We focus on improving the lives of our clients and their families in ways they envision. If you would like support, please contact us.
