How to Help People Who Don’t Know They Have Dementia

Anosognosia?

Guest article by Sarah Schwarcz

Memory loss, whether it’s from Alzheimer’s or dementia, is difficult for both those living with it and for those they love. Denial of the condition can make it even worse, but often denial is more than simple head-in-the-sand behavior. Anosognosia is a condition that makes it difficult, if not impossible, for some to acknowledge they are suffering from a memory-affecting disorder.

Anosognosia: What is It and What is the Cause?

Simply put, anosognosia is the complete lack of awareness that one is impaired. It’s a diagnosis common to stroke survivors, with up to 77 percent unaware that they have undergone neurological changes after the event. A stroke isn’t necessary, though – it can also affect otherwise healthy people that suffer from dementia and Alzheimer’s.

The cause is damage to the brain in the centers that control perception. Usually, this damage occurs in the frontal lobe, either from damage caused by a stroke or deterioration from dementia.

Alzheimer’s and Anosognosia

Nearly 81 percent of people with Alzheimer’s are likely to have a degree of anosognosia, according to research by the University of Florida [Updated 8/24/2021: URL to PDF no longer available.]. This is because Alzheimer’s is a direct cause of deterioration in the right frontal lobe of the brain. It can be difficult to spot, since it often becomes lost to other memory issues related to Alzheimer’s, but it can also make Alzheimer’s treatment more difficult.

How to Tell If It’s More than Just Denial

Not all cases of refusal to acknowledge the problem are anosognosia. Denial is also a common trait in Alzheimer’s patients, especially during the early stages of the disease. Some symptoms of anosognosia as it relates to Alzheimer’s are:

• anger at those that show concern or point out forgetful behavior.
• inability or difficulty in handling daily tasks, from paying the bills to practicing personal hygiene.
• spontaneous or out of character behavior.
• making up or rewriting history to fill in missing details from both recent and past memories.

What Can You Do?

In the end, it doesn’t matter whether it’s plain denial or anosognosia – the goal is to help people get the help they need even if they don’t think they need it. Ignoring the problem won’t make it go away, and it could put your loved one in danger. The following steps can aid you when dealing with anosognosia and Alzheimer’s.

1. First, minimize the person’s responsibilities. For example, take over meal preparation, bill paying, and outside errands.
2. Next, use positive words and actions when helping people or speaking about their condition. Be gentle and empathetic so you don’t raise any ire.
3. Provide structure by setting up a daily routine and sticking to it. It may be necessary to bring in a home health aide to help keep people to their routine.
4. Finally, seek outside help when possible. Express your concerns to the doctor and look into memory care and Alzheimer’s therapies.

Senior Planning Services has been helping seniors and their families for many years with their long-term care planning and Medicaid eligibility [UPDATE 5/11/2020 URL no longer connects to page]. Being proactive and bringing in outside support can help both you and the person you care about through this trying time. Just because they think they are fine, doesn’t mean that they don’t need your help.

Sarah Schwarcz is Business Development Representative and staff Writer at Senior Planning Services–guiding seniors and their families through the Medicaid maze. Sarah loves nature, blogging, and spending time with her family.