Anosognosia & Alzheimer’s: What You Need to Know

Jul 8, Alissa Sauer

Because of the nature of dementia, it is entirely likely that your loved one does not realize he or she is suffering from the disease. More than denial, this condition is called anosognosia and it is a lack of awareness of impairment. Affecting up to 81% of people with Alzheimer’s disease, anosognosia is a medical condition that can play a major role in caregiving and treatment plans.

Learn more about anosognosia and its effect on people with Alzheimer’s disease and related forms of dementia.

What You Need to Know About Anosognosia

It is very common for people recently diagnosed with a chronic condition to be uncomfortable admitting the diagnosis to themselves or others. However, for many people diagnosed with Alzheimer’s disease or a related form of dementia, the rejection of the diagnosis can be long-lasting. This is known as anosognosia and it means to have a lack of awareness or insight. Defined as the “lack of ability to perceive the realities of one’s own condition,” anosognosia affects up to 81 percent of people living with dementia.

Anosognosia is commonly seen in people diagnosed with Alzheimer’s disease, brain tumors, Huntington’s disease, and stroke. Often dismissed as denial, anosognosia actually results from real changes in the brain. It’s not stubbornness or even a defense mechanism.

Symptoms of Anosognosia

Some symptoms of anosognosia are very similar to symptoms of dementia and to make diagnosis more challenging, anosognosia may be selective in nature. This can make it difficult to diagnose and difficult to differentiate from denial.

Symptoms of anosognosia include:

• An inability to keep up with daily tasks or personal grooming and hygiene
• Difficulty managing finances
• Decreased inhibition in speech and lack of self-awareness
• Anger when confronted with a lack of self-care, poor decision making, and forgetfulness
• Exaggeration or believing things are true, even though they are not

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Caregiving for Someone Who Does Not Know They Have Dementia

Caring for someone who has dementia and anosognosia can be very challenging. For caregivers who are trying to help someone who cannot acknowledge they need help can lead to refused medical treatment, evaluation, and delayed diagnosis.

However, if treatment and proper care is not received, people can put themselves or others in danger. These tips can help caregivers care for someone who does not know they have dementia.

1. Do not try and convince your loved one they need help 

Trying to convince someone with anosognosia that they are ill can be incredibly frustrating for all parties. Mitigate symptoms and encourage your loved one but do not try to repeatedly make them understand something they are not capable of understanding.

2. Provide structure

A daily care plan for dementia caregivers can be extremely helpful for people living with anosognosia. Provide your loved one with a gentle structure that includes personal care time, downtime, and household tasks.

3. Involve your loved one in decisions

As dementia progresses this can become difficult, but try to involve your loved one in decisions when you can. Acknowledging their autonomy and independence is very important and can help caregivers and those being cared for work together in an effective and positive way.

4.  Consider memory care

There may come a point where you are unable to care for your loved one or the responsibility of caregiving becomes too great for one person. This is normal and why memory care communities are available to partner with dementia caregivers, downsizing unnecessary tasks and providing people with dementia expert care.

Are you caring for someone with Alzheimer’s or dementia who also has anosognosia? How have you helped them get the care they need? Share your personal stories in the comments below. We’d love to hear from you!