Problems with Anosognosia: When a Loved One Doesn’t Realize They Have Senior Dementia

When we are faced with a major problem or health crisis, often, our first instinct is to bury our heads in the sand and ignore it. On one hand, this makes senses, albeit in a convoluted way. Our brain is trying to protect us from the unpleasant feelings and associations that the problem may bring. It’s also processing and adapting to this new information in order to reach a solution.
Most of us eventually accept that there is a problem and take active steps to solve it. However, for some people (like those with senior dementia), this is not so easy. They may go into denial about the issue, refusing to acknowledge and deal with it. But there are also individuals who have anosognosia, or a “lack of awareness of impairment.” Studies have shown that this may affect up to 81% of those with Alzheimer’s disease.[1. “A diagnostic formulation for anosognosia in Alzheimer’s disease,” March 20, 2006,]

Facts about Anosognosia

Anosognosia is more than just a coping mechanism, like denial. Denial is the result of cognitive function, which suggests that areas of the brain that process information are still working (although in a roundabout way, as we mentioned). Anosognosia, on the other hand, is the result of physical damage to the part of the brain that affects perception.
This can create difficulties for caregivers, especially when they try and offer help to someone who is anosognosic. The person may insist they can complete tasks on their own when they clearly can’t. Some of these tasks are dangerous, such as operating a car or pair of scissors. But they can be as mundane as failing to take their medications as prescribed—or at all. However, working around anosognosia is key, because many times the help or treatment refused are the very ones the patient needs to survive.

How to Cope with Your Loved One’s Anosognosia

With denial, there are various methods you can employ to help the person cope with their illness.[2. “Dealing with Denial,”] Some of these are very direct (for example, you may have heard of the “intervention” method when bringing a person face-to-face with their alcohol or drug use). Others are more subtle, seeking to address the underlying fear that keeps the individual from admitting their problem.
However, these methods are unlikely to be effective with anosognosia. That’s because the victims may not be mentally capable of acknowledging their issue—ever. And although that may seem like an insurmountable barrier to coping with the illness, it’s actually not. As long as you are aware of your loved one’s condition and are taking steps to treat it, there are ways to deal with the day-to-day stress anosognosia can bring. These ways include:
Keeping your communications positive: When your loved one has trouble with tasks or accepting help, be kind and empathetic when offering assistance.
Making joint tasks part of the everyday routine: Your loved one may be more inclined to accept help if it becomes normalized. For instance, start making a habit of going grocery shopping together every week, rather than asking if your mom needs help because she’s not supposed to go alone.
Being subtle when bringing up concerns: Language such as “Let me help you cook on the stove; you know I love being in the kitchen with you,” works better than “You can’t do that by yourself anymore—you’ll get hurt!”
Getting professional help: When caregiving tasks become too overwhelming, don’t hesitate to seek the services of a home health agency. They can provide staff with experience in dementia, anosognosia, and more.

Stay Positive when Someone You Love Has Senior Dementia

Although coping with senior dementia and anosognosia can be an exercise in frustration, it’s important to stay positive. By understanding the condition, as well as using the tips and tricks above, you can help keep your loved one safe—whether or not they’re aware it’s something they need.
If you are unsure of how to best help an aging loved one, the trained and compassionate staff at the Institute on Aging is here to help you make that decision and gain the best in at-home care for older adults. Contact us to find out more.

Institute on Aging

Institute on Aging

Related Posts


Give our dedicated Client Service Specialists a call. We are ready to help.

Follow Us

As we approach the end of #SocialWorkMonth, Institute on Aging would like to take a moment to recognize and celebrate the incredible work being done by all of our Community Living Fund and HomeSafe social workers.

These dedicated professionals have shown unwavering commitment to providing exceptional care to clients and building strong, vibrant communities. We are consistently impressed by the passion and expertise they bring to their work and their ability to connect with clients in meaningful ways. Our CLF and HomeSafe social workers have risen to this challenge time and time again, going above and beyond to support the individuals and families they serve.

At Institute on Aging, we are grateful every day for our social work teams' hard work and dedication. We want to extend our heartfelt thanks to these outstanding professionals for all they do to make a difference in our clients' and communities' lives. You truly embody the spirit of social work, and we are honored to have you as part of our team.

#ThankYou #SocialWork #Appreciation #SocialWorkers #Gratitude #SocialWorkerAppreciation
Sophia became a part of the Community Living Fund team in December 2022, joining at a critical time when additional coverage was required for certain cases. Additionally, CLF was in the process of introducing a new assessment and implementing CalAim services for San Francisco members.

Sophia has been an essential contributor to these ongoing initiatives while effectively managing a caseload of Intensive Case Management (ICM) clients. We were thrilled to receive positive feedback about her support for the TRCS program, which demonstrates her dedication to the agency's mission. CLF is grateful to have a Case Manager like Sophia, who is passionate about serving San Francisco's vulnerable population.

#SocialWorkMonth #WeAppreciateyou #ThankYou #SupportatHome #CaseManager #SocialWorkerAppreciation
Three and a half years ago, Maggie Fang started her journey as an Assessment Specialist in the Support at Home Program at IOA. Her excellent people skills enabled her to manage a caseload of older adults and individuals with disabilities, helping them receive homecare to age in place. Maggie was selected to pioneer the Temporary Respite Caregiver Support program, and we are delighted to have such a skilled and dedicated individual leading our newest program at IOA. Thank you, Maggie, for your exceptional work! 

#SocialWorkMonth #WeAppreciateyou #ThankYou #SupportatHome #CaseManager #SocialWorkerAppreciation
Join us at the Adult Day Program at the Enrichment Center as Caregiver Coach Alex shares with us the incredible support and care provided to participants living with dementia. Clients enjoy various engaging activities, from music therapy to art classes, designed to stimulate their cognitive and physical abilities. The skilled staff at the Enrichment Center also provides caregivers with much-needed support and respite, allowing them to take a break and attend to their needs. If you or someone you know is looking for support in caring for a loved one with dementia, the Adult Day Program at the Enrichment Center in the Presidio is an excellent resource for you! 

Learn more by visiting the link in our bio! 

#DementiaCare #EnrichmentCenter #AdultDayProgram #CaregiverSupport #Presidio #Dementia #Memory #Caregiver