We know mom has dementia, that’s already been diagnosed. We watch as her ability to care for herself declines right before our eyes. We see her forgetfulness and confusion, but now, to make matters worse, she is refusing medical care and treatment. Does she realize she needs help? Does she know she’s ill? Why can’t she see what we see?
Many seniors who have been diagnosed with Alzheimer’s disease or other forms of dementia refuse to stop driving, won’t accept in-home care and resist the idea of moving to senior living facilities not because they’re in denial but because they are unaware that they need assistance. This lack of awareness or acceptance of a medical condition is known as anosognosia.
Anosognosia is a neurological condition where the individual is unaware of their condition. Levels of awareness can vary depending on the person and can increase or decrease over time. This condition is extremely common in stroke victims and older adults with Alzheimer’s disease or dementia; 81% of patients with Alzheimer’s disease experience some kind of anosognosia.
Many people think of this condition as psychological denial, but this isn’t the case. People with anosognosia are genuinely unaware of any decline in their neurological or cognitive skills. Their condition is caused by physical damage to the brain rather than a current psychological state. A loved one with anosognosia is not making the conscious decision to ignore or deny their physical/mental condition, but rather is unaware of it due to their neurological condition.
As with most dementia behaviors, learning more about anosognosia can help you stay calm and find workarounds to keep your loved one safe.
For many caregivers, anosognosia can be harder to deal with than the actual symptoms of the cognitive disorder. Aging loved ones who are unaware of the decline in their cognitive abilities may not respond well to conversations around not driving, handing over the management of their finances, and other daily activities like cooking or cleaning. Here are some things to keep in mind:
Don’t try to force your parent to recognize their condition or disability. Your loved one has no control over their denial of their disorder, and while recognizing this won’t change any of the actual problems you have to deal with, it will reduce some feelings of anger and frustration towards them.
Levels of awareness change as time passes, but also vary in different areas. Your loved one may be unaware of their inability to drive safely but might easily recognize the decline in their memory recall.
Encourage your loved one to be completely honest with you. Although they can’t see the decline of their cognitive abilities, they may feel uncertain or confused regarding their own thinking process. Anosognosia takes away the ability to recognize impairment, but your loved one may still realize that something is wrong. As such, they may try to downplay their symptoms and experiences to communicate what they are still capable of doing to hide what it is they are struggling with.
In the case that your parent refuses to get medical help when they need it, you may need to intervene in some measure. If they don’t recognize that there’s a problem, how does that information get to healthcare providers such as their physician or someone in a hospital emergency department? You may need to intervene. Even if your loved one refuses to accept their problem, it’s important to get them the help they need.
Seeing your loved one struggling with anosognosia can be very difficult to deal with. Oasis Senior Advisors are here to help you find the resources you need. Call us at 475.619.4123 or 914.356.1901, or fill out this online form.