Anosognosia and Alzheimer’s Disease: Coping Strategies

The relationship between anosognosia and Alzheimer’s disease has been well documented. It is a medical condition that inhibits their ability to develop the insight necessary to understand and acknowledge their specific condition. It is most common in people who have Alzheimer’s disease however it is also common in those with bipolar disorder or schizophrenia.

Anosognosia Diagnosis

From the perspective of friends and family, it will be difficult to differentiate between denial and anosognosia. This is due to the varied experience of people with dementia or mental illnesses. Anosognosia, in particular, can have a diverse effect as well. Someone with anosognosia may be on a sliding scale of completely aware to completely unaware of their conditions, and their perspective can change from day to day. They may recognize some of the more obvious symptoms and not other more subtle symptoms. Whatever they may recognize and their awareness is open to fluctuation.

 

Your primary physician will have an assessment tool to assist in diagnosis.

The assessment tool will clarify the following:

• Do they recognize that they have symptoms of their condition?
• Do they realize their symptoms are a result of a health condition?
• Are they aware of the social consequences of their symptoms?
• Do they understand they need treatment?

Anosognosia Treatment

If your doctor has diagnosed your loved one with anosognosia, that is a step towards clarity, but not necessarily towards treatment. Anosognosia is difficult to treat and is more based on the underlying condition that is causing it, for example, Alzheimer’s disease. For those who have Alzheimer’s disease or other forms of dementia and mental illnesses, it may be more beneficial to seek treatment from a therapist, psychiatrist, or counselor. Therapy, including motivational enhancement therapy, can help support someone who is struggling to be aware of their condition and will help them take a closer look at their life and symptoms. This therapy does not convince people of their anosognosia, but rather helps them understand the benefits of healthy goal setting to improve their quality of life.

Coping with Anosognosia

If you are the primary caregiver of a person with Alzheimer’s disease and anosognosia, then you may find it challenging to navigate their health and medication routine. There are well-known strategies that will help you, and them, navigate their complex relationship with their condition. The LEAP method is an easy-to-remember acronym that will help support your relationship with your loved one. It is centered on your connection which will help build trust and minimize defensiveness.

1. L – Listen to your loved ones
   Make sure you validate their feelings and really hear what they have to say.

1. E – Empathize with their experiences
   Help them feel understood and cared for by empathizing with their experience.

1. A – Agree with them if you can.
   Focus on what you have in common and do not dwell on what you cannot agree on.

1. P – Partner and build trust
   By fostering a strong relationship built on cooperation and respect, you can look for solutions that work.

For someone living with Alzheimer’s disease and anosognosia, what they need most is your support in order to consistently follow their health routine. Every day may be different and challenging, but try to be calm and peaceful, so they can follow suit. Be mindful of their condition, they may not be acting stubborn or resentful on purpose, and they may be unaware of their symptoms and their effects. If you notice symptoms of anosognosia, it is important to make an appointment with their primary care physician to ensure they are receiving the care they need.