Anosognosia and Alzheimer’s

What is Anosognosia and why does it occur?

The word Anosognosia literally means “to not know a disease” and involves so much more than just being in denial.  Anosognosia is hard to define, but researchers know it results from “physical, anatomical changes or damage to the part of the brain that affects perception of one’s own illness.”  Many studies also suggest that the deterioration of the frontal lobes could also be a main cause of Anosognosia. The frontal lobes of the brain play an important role in problem solving, understanding things in context, and making sense of events and interactions. According to Dr. V.S. Ramachandran, the right side of the brain has similar functions to the frontal lobes, including detecting abnormalities and incorporating new pieces of information into our sense of reality. When the right side of the brain is damaged, the left side of the brain tries to over compensate and maintain a sense of belief by using denial or rationalization.

Anosognosia and Alzheimer’s

The Treatment Advocacy Center states that Anosognosia is often recognized in those with Alzheimer’s, brain tumors, Huntington’s disease, or stroke. It is extremely difficult for family members to make progress with their loved one’s condition if that person is showing signs of Anosognosia because they often cannot tell the difference between Anosognosia and simple denial. Aplaceformom.com gives a list of several signs to look out for in your loved one if you are trying to distinguish between Anosognosia and denial:

  • Lack of hygiene or not keeping up with daily tasks
  • Trouble managing money and bills
  • Being more spontaneous or less inhibited in conversation without concern for their own behavior
  • Becoming aggressive when confronted with forgetfulness, lack or self-care, or poor decision making
  • Making up answers they think are true, but the details are imaginary or may deal with things that happened in the past

6 ways to help someone who doesn’t know they’re ill

A diagnosis of Anosognosia does not come from a non-physician, such as a family member or other caregiver. If you suspect your loved one might be experiencing a mental illness or is suffering from cognitive decline, make an appointment with a physician or psychiatrist and discuss the symptoms with them. Dailycaring.com gives 6 ways you can help a loved one who is suffering from Anosognosia.

Don’t try to convince them they have dementia

Trying to convince your loved one through reasoning or evidence that they have dementia or another cognitive impairment disease is not going to help you. Often times, it will only end up upsetting them even more. What you can do instead is to make more subtle changes that will help them live more safely. Try to remain calm and validate their feelings, and when expressing your concerns, remain subtle and positive.

Work with their doctors and care team

When your loved one’s dementia symptoms begin interfering with their daily lives, it is time to get their care team involved. Their care team can include doctors, relatives, friends, other caregivers, or assisted living staff. Explain to the team the problems your loved one is having with not comprehending the fact that they have dementia. Work together to provide care for the older adult and help them without waiting for them to ask for help or making it clear that they have a problem.

Discreetly make their life as safe as possible

Finding ways to make your loved one’s life simpler and safer will put you both at ease. Many people with Anosognosia may still try to drive, cook, manage money, or do other activities that may be dangerous due to their cognitive impairment. Without giving dementia as the reason, find creative ways to make changes in their activities and stop them from doing potentially dangerous ones. Use a positive approach and present your help with driving or managing finances as a way you are relieving a burden rather than taking control of their life. Allow them to do as much as they possibly can so you can help to preserve their pride and keep them in a happier mood.

Avoid correcting them and having confrontations; pick your battles

Those who suffer from dementia may experience a different version of reality due to the damage the disease has caused to their brain. Dementia experts recommend trying to see things from your loved one’s point of view, rather than trying to correct them. Those who suffer from cognitive impairment are losing their ability to correctly process information, which only causes fear, anger, and frustration. Unless the situation raises a serious safety concern, let your loved one handle things the way they want to.

Present solutions positively and subtly

The less your loved one feels that you are limiting them for reasons they do not understand, the less likely they are to become angry or resist your help. When someone is suffering from Anosognosia, it is important to offer creative solutions and shed a positive light on every situation. For example, if your loved one wants to take a walk outside, offer to go with them because the weather is nice and you could use the exercise, rather than telling them they cannot go outside by themselves because they are likely to get lost or fall.

Learn more about dementia and dementia care techniques

The most efficient dementia care and communication techniques are not something someone can just figure out and are often the opposite of our instincts. Being unaware of these techniques can also add more stress and frustration for both you and your loved one. This is why educating yourself and learning as much as you can about the disease is so important and will help improve the quality of life for you and your loved one.

 

Sources:

http://dailycaring.com/6-ways-to-help-someone-who-doesnt-know-theyre-ill-anosognosia-in-dementia/

http://seniorsmatter.com/anosognosia/

https://newoldage.blogs.nytimes.com/2014/01/22/when-they-dont-know-they-are-ill/

https://www.aplaceformom.com/blog/3-4-14-anosognosia-and-alzheimers/