Anosognosia and Alzheimer's Disease

What is Anosognosia?

It is typical for people newly diagnosed with a chronic illness to feel uncomfortable in admitting the diagnosis to themselves or others. Even so, the rejection of a diagnosis can be long-lasting and a disease itself. We refer to anosognosia, a disease that causes a lack of awareness or understanding of one's condition. Described as the "lack of ability to perceive one's own condition's realities," anosognosia affects up to 81% of people with dementia.

Anosognosia Medical Definition

Anosognosia is a loss of capacity to grasp the facts of one's situation. In other words, anosognosia is the reluctance of a person to agree that they have a disease that fits their symptoms or a formal diagnosis.

Symptoms of Anosognosia

signs of anosognosia are somewhat similar to dementia symptoms, and anosognosia can make a diagnosis more difficult, as it can be selective by nature. Some anosognosia symptoms are:

  • Inability to keep up with tasks or personal hygiene

  • Difficulty managing finances

  • Decreased inhibition and lack of self-awareness

  • Gets angry when confronted with a lack of self-care

  • Believing things that are not true, exaggerating

 

What Causes Anosognosia?

Experts think that anosognosia derives from damage to a region of the brain involved in self-reflection. When a person suffers from anosognosia, they can no longer appropriately update their self-image. What part of the brain is responsible for anosognosia?  Their brain's frontal lobe is impaired, a phenomenon that also occurs with disorders like schizophrenia and bipolar disorder. For this process to function correctly, the brain's frontal lobe needs to take in the new material, arrange it, use it to edit their self-image, and remember the current edition. When this fails to happen, anosognosia makes its entrance.

Who Is Affected By Anosognosia?

In individuals with severe mental illness, anosognosia is normal. According to health experts worldwide, about 40 percent of people with bipolar disorder and 50 percent of those with schizophrenia have it. In contrast, some psychologists consider that the statistics are much higher, as they say, that 57 percent to 98 percent of people with schizophrenia have it. Many people suffer from neurological conditions, so it's not rare for anyone who has Alzheimer's to get anosognosia as well. Patients with strokes sometimes do too.

Alzheimer's Disease And Other Forms of Dementia

Anosognosia is part of the group of forms of dementia, which includes Alzheimer’s as well. Anosognosia can be diagnosed along with:

  • Depression
  • Traumatic Brain Injury
  • Stroke
  • Brain Tumors
  • Huntington's Disease
 

Anosognosia And Alzheimer's Disease

There are many different forms of dementia, which are caused by many factors. Mixed dementia, for example, is a disorder in which there are simultaneous brain modifications of more than one form of dementia. The most common form of dementia is Alzheimer's disease—responsible for 60-80 percent of dementia cases. Even so, dementia is not an ordinary component of aging. A degenerative brain disease, such as schizophrenia, or anosognosia, typically starts in late life and results in progressive dementia.

 

Diagnosing Anosognosia

 

How is anosognosia diagnosed? Suppose a care recipient or a loved one has been diagnosed with a disorder that may be associated with anosognosia. In that case, a doctor may recommend them to see a psychiatrist or another mental health specialist. Anosognosia can be detected early on by a specialist who can detect even minor behavior changes.

 

Treating Anosognosia

 

How is anosognosia treated? To treat anosognosia, family and friends can consider treating their loved one with the next options:

Antipsychotic therapy

To relieve schizophrenia or bipolar disorder symptoms, a doctor may prescribe drugs known as antipsychotics.

Motivational enhancement therapy (MET)

MET consists of motivating others to either adjust their self-image, admit that they have a disorder, and encourage them to obtain medication for their condition.

MET also consists of having others look critically at their symptoms, habits, and experiences. This also leads to an understanding that facts suggest the presence of a condition in elders.

Caregiving for Anosognosia

Caregivers are essential when it comes to dealing with people who suffer from any form of dementia. In the case of anosognosia diagnosis, a caregiver may apply the next tips in their lives to maintain peace and respect in their relationship with the patient or loved one.

Anosognosia Caregiving: Do’s and Don'ts

Do's:

Giving them a structured routine

A caregiver should provide a gentle and structured routine that covers time, downtime, personal care, and household duties.

 

Considering Memory Caregiving

The situation may come to a point where a family member cannot take care of their loved one’s health details anymore, a time when the duty of caregiving becomes too great for one person. This is a natural process and is why there are communities in memory care that are ready and available to work with dementia caregivers, downsize unnecessary activities, and offer expert care for people with dementia.

Making them trust you

It is highly recommended caregivers learn about the disease and how their loved ones can be affected. It is vital to keep anosognosia patients calm and happy as a way of helping them cope. Understanding the situation and being empathetic about it is perfect to start building a trustworthy relationship.

Don'ts

Trying to convince them they have a problem

For all parties involved, trying to persuade someone about having anosognosia can be extremely stressful. Caregivers and people around a person with anosognosia may mitigate the signs and help their loved ones understand what they cannot understand. Still, they shouldn’t try to force the full understanding of their illness situation or insist that they have a severe problem that can immediately turn them into outcasts.

Take care of them all by yourself

For individuals dealing with anosognosia—and most importantly, their families—a regular care plan for dementia caregivers may be beneficial.

Distance yourself from the root of the problem

Avoiding the situation or consciously distancing yourself from the root of the problem can create an ambiguous relationship between the caregiver and the care recipient. If this happens, any connection is most likely to fail over time.

Try finding something to agree with

If an elder with anosognosia still needs more time to process their situation, finding something to agree with—outside of the subject of anosognosia—can help caregivers cope with the situation.

Build Trust to make them cooperate

As mentioned before, trust will play a massive part in the whole process. Here are some tips for doing so:

  • Speak facts

  • Admit it when there is something that’s out of your knowledge.

  • Accept when you're wrong

  • If you say you'll do it, do it

  • Explain your thoughts

  • Extend that trust to others

Is your loved one suffering from anosognosia? Do you think they may be presenting some signs and need guidance in the matter? At Right At Home, we are always available to answer your questions on anosognosia—or other forms of dementia— and offer you our certified caregivers services. Call Right At Home today and let us handle your loved one’s health with professionalism and servitude.

Bruce Gropper
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