COG Selftest

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"There's nothing wrong with me!" Caring for a loved one who is unaware they have a problem.

Anosognosia is a term used to describe a person who is unaware of or denies the existence of their condition or problem. Some researchers estimate 20% of Alzheimer's Disease (AD) patients suffer from Anosognosia. My own research puts this estimate closer to 50%.

If you have a loved one suffering with Anosognosia you are probably very familiar with this concept, even if you didn't know the medical term for it. AD patients with Anosognosia will argue with you if you point out deficits in memory or basic functioning. They tend to believe that they can function normally - still manage the finances, for example, when it is apparent to you that their cognitive deficits impair this ability.

AD patients with Anosognosia can be some of the toughest for caregivers to manage, and can create greater stress on loved ones than those without Anosognosia. It may help to remember that this is a medical condition and that special care is needed to manage these individuals. It is often important to ensure that some individuals with Anosoagnosia not drive vehicles, as this can present a dangerous situation.

Since the patient may not recognize the need for medication, creativity is helpful here. For example, I sometimes recommend that caregivers of patients using the anti-cholinesterase patch place the patch on the patient's back (rather than chest), to keep them from seeing and removing it.

It is frequently best not to argue with patients with Anosognosia when the issues are often of little consequence. Important issues however, should be dealt with firmly and directly, especially when it's time to explain to them that certain activities are dangerous for them, such as: driving is not safe!

As the caregiver, always remember that patients with Anosognosia have a distorted self-awareness and are not just trying to be difficult.

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