Do they know they have memory/cognitive issues?

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Do they know they have memory/cognitive issues?

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My loved one has the start of dementia - testing said somewhere between MCI and dementia. Each day is different. But there seems to be no understanding that there is a problem. The cognition is completely different and memory issues are getting bad, but he is in no way aware of it. Is this common? Should we push to make him understand?

Alzheimer's & Dementia Anosognosia Cognitive Decline

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I wrote a similar question a few months ago. There will be no convincing your husband if the progression of his disease is at all like my husband’s. What I’ve had to do is work around him. I grab the keys and insist on driving. I’ve moved all our bills to automatic payment. I tell lies when necessary to keep him safe.

I am fortunate that the progression of my husband’s Alzheimer’s has been relatively slow. Still, the decline is real.
This is not about denial. The official name is anosognosia but there are no magic words to get through to that cognitive scramble that is Alzheimer’s. My husband is on 2 meds and sees the neurologist 3 times a year. I’m just grateful he agreed to that.

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In my opinion, I think at some level they know something isn't right. However, the brain is design to protect it self. The brain will figure an answer to a question or in their case, a situation; for example, the person has early dementia and places the milk in the cabinet. They later find the milk in the cabinet and may think, "wow, why did I do that?" At first that person may not think anything of it, but in the background the brain is searching for answer and it comes up as being tried or stress. However, as this person keeps doing these things they know something is very wrong with them. Then the brain goes into protection mode and the brain will continue to search or tell the person your just tried or stress or whatever. So, I do think people know at times, but the brain is design to save it self (the person). I hope I didn't confuse you!

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https://www.agingcare.com/authors/rick-phelps

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Wow. Helpful -- and terrifying.

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5 years ago my step fathers wife did, today no. Although she was in denial, she knew.

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It really depends upon the person. Every case of dementia is different, not just in the underlying cause, but even the course it takes.

For our mother, it was just outright denial. In her mind she was fine, independent and could cook (none of which were true!) Her excuse when forgetting something is that she is old and entitled to forget things now and then. We also could NEVER use the word dementia around her as she is convinced this means someone is off their rocker (aka crazy), which certainly is NOT the definition, but in her ignorance that IS what it means. This was her take on the word even before she showed any signs.

She still is clueless about how much she knows or forgets. It was first noticeable when she was around 91, just turned 96 yesterday (going on 2!!)

Sometimes in the early stages, especially when the person clearly KNOWS something is amiss, you might be able to discuss it with them. Generally by the time family and/of friends realize there is an issue, it might be too late.

"Pushing" someone to understand and/or accept certainly isn't the right way to approach the issue. Most often short-term memory is affected and that would mean having to tell the person over and over and OVER again - not a pleasant thought! If you try this approach and they accept it, fine, but it doesn't mean it is over and done with. As dementia progresses, they likely will forget that discussion. If you try it and meet with denial and/or resistance, it is best to leave that discussion by the wayside. If the person becomes agitated over having difficulty and/or not understanding what is happening to them, it might be best to just try redirecting/refocusing them onto something else, something they like or enjoy.

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My SIL hadn't a clue that she had Alzheimer's! But she should have known something was amiss. About 4 years prior to diagnosis, she had a precursor - she was driving in her own neighborhood with 2 of her grandchildren in the back seat of her auto and she entered a highway, which was clearly marked in red, "DO NOT ENTER." Only by the grace of God and other drivers alerting her, she got turned around and was not injured, nor were her dear grandchildren. Fast forward to 2017 - at diagnosis - she was receiving tons of overdraft notices from her bank, but hadn't a clue!! This was a woman who used to balance her checkbook to the penny. She still said NOTHING! It was one of her sisters who had a talk with her and said "I have to tell you C ---, I'm concerned about you." That sister took her to a neurologist, who gave C an M.R.I., which is the gold standard to detect for Alzheimer's.

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I have wondered the same. My MIL is sloooowly getting worse. She thinks she cleans but doesn't, buys multiple bags of cheese, containers of ice cream as she doesn't remember she bought them the last time she went to the store. There can be so much stuff in her fridge that there's no room for more. She HAS to know she's not the woman she used to be. She will play cards for HOURS, which she never used to do. But she is very upbeat and laughs it all off. She won't go see a doctor. Won't, won't, won't. And you cannot force her. We are just in a holding pattern waiting for things to get bad. (She spends six months in North Idaho, six months in So Cal. They have little houses in each state. It is just like an avalanche waiting to come crashing down is what it feels like.) No doctor sees her regularly because she splits the year in different cities. She insists on writing her own bills and gets offended when we offer. It is very unnerving at this not-quite stage.

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At some level, they know, but don't want to "know", so they refuse to believe it is so. As things progress, and more people point things out to you, or to them, it will become more evident. Begin to get information regarding what lies down the road...placement in a facility, support group for yourself, getting ready for the long haul, etc. Get an appt. set up with the doctor and take your person to the appt. and hang on to the diagnosis paperwork so that you will have that as a "start date" of when this journey began for you/them.

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NO NO NO - don't push them to acknowledge their condition because all you will do is make them unhappy & they won't remember it in the long run -

I felt with my mom that it was a blessing in disguise that she was 'blissfully unaware' - when she would mention that she forgot about something then I didn't make a big deal rather said 'do you want me to write it down for so you don't forget again' or say that 'I will remind you of it for next time & that's what you have me for'

A confrontation won't achieve anything but hard feelings - in order to make things easier on both of you the best thing to do is to have your LO think of you as 'always on their side' , 'the bringer of treats' , 'my favourite person' etc -

My mom thought I was stealing from her but by always bringing her some little treat she switched her thinking of me from 'stealer of stuff' to 'treat bringer' & that made things better for both of us - these treats don't have to be big rather items from the dollar store[St. Paddy's day shamrocks etc] or a specialty coffee[mom liked 1/2 decaf coffee & 1/2 hot chocolate] or a doughnut

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I totally agree - my mom has dementia issues and I believe it is a blessing that she is unaware. I think it almost protects her from anxiety. She doesn't know how old she is, so she doesn't worry about that and just takes life as it comes. She still seems to recognize me and my siblings and has long-term memory recall, just not short-term.

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Recently I've wondered the same. My Dad, who has been on Alzheimer meds for years, has recently insisted he doesn't have it because the meds he is on has PREVENTED it. He has been a roller coaster for years. He believes what he says when he says it and he often says what he knows we want to hear. My Mom has been exhibiting signs of memory loss and paranoia just this year. She was a nurse and fully understands where this journey is going. Between the two, the blaming of lost items and misunderstandings has escalated. Today is their move into independent living in a 55+ community that has AL and memory care. I am so grateful for this online community openly sharing compassion and experience.

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I believe they know something is amiss. They don't understand why they can't remember the things they used to. Our parents say 'ALL people over 80 get this way". Our neurologist advised us not to tell them stating they could not "process" the diagnosis. They would hear it but not understand what ite meant. So we just play it off as a memory problem. Because yes... we repeat this over and over and over again.

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Totally agree! They can’t and don’t need to understand because there is NOTHING they could do, at this point, to make it better. I knew a man who had cancer, but refused the word and talked about “his little infection”. He was perfectly intelligent and aware; just didn’t want to have it be the topic of every conversation. So we have also adopted a policy of just referring to my husband’s “forgetfulness” in passing, and letting it go at that. I used to launch into lectures about which part of his brain was broken, and what that meant to the issues he was struggling with, etc. Wasted energy! I was trying to give him, in his new and limited reality, what I in my current and thank God, not declining state would want. Two different worlds. It has worked much better and I’m quite sure it has kept me from engaging with several potentially painful and explosive conversations. “Oh, honey, that’s just that darned forgetfulness again! Let me help you find that.“. Or the all-purpose, “Thanks for telling me that.” (Even when it’s the 25th time.). Or even, “I’ve forgotten where xyz is. Do you happen to remember?” He won’t, but it is a way of respecting his adulthood and the fact that all of us forget things from time to time, not just him.

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Even if you told your loved one they have a cognitive issue chances are they would forget what you told them and you would have to open up the wound on a daily basis to have the same conversation. It would be like they had a new painful conversation over and over again. It seems cruel to me.

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Both my DH and my dad knew about their declining memories. I chose to reinforce the positive and not the negative.

With my dad it was reminding him of all he still had, like being able to live on his own.

With my DH, he lost his memory after a nasty 2 month bout of pneumonia. When the prescription medications didn't work, I turned to alternative measures and started him on 500 ppm Colloidal Silver Nasal Spray which finally killed the pneumonia. Then I started him on Iodoral (iodine) and within days most of his memory came back.

Dementia is a label - look past the label and focus more on nutrition since poor nutrition has been linked to dementia as far back as the 1970's; I was hearing about Senile Dementia was linked to malnutrition because seniors start eating "fast" foods, instant meals. We're consuming too many chemicals in our prepared foods and heat & serve meals. Try to get back to natural and less packaged meals. It seems that nothing is made from "scratch" anymore.

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Good for you, Ray.

I am not a medical doctor nor am I recommending any course of action. For any course of medical/health care get your doctors approval. I have applied the following strategies to help my loved one and the strategies ( with an ND's approval) have been very effective.

1. Nutrition: blood work can determine what the individual needs to support their health. But, fresh organic foods would probably be included, juicing, smoothies.
2.Clean filtered water
3.Supplements ( some ND's claim that Gingo Biloba helps).
4.Sleep
5.Exercise like walking in the sunshine and earthing or Tai Chi and/or (what they are able to safely do).
6.Detoxing ( can use lemon and/or cilantro and more).
7. De-stressing (like massage, reiki, reflexology, aromatherapy, meditation of the person is capable of this type of organized thought.)
8. Reading and being read to is important. Learning new information. 9.The individual needs to be loved. show them love if you are the caretaker.
10.And have a social outlet of some kind.
11.And to find a purpose in their life as it is.
12.Allow the person to grieve their loses ( like not living in their home, not being able to do what they used to do,etc).
13.Having someone to talk to about their fears and loses. Maybe an Elder Psychologist.
14.See the Bredesen Prodical and/or
15.Amen clinics.

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I don't think you should push to make him to understand. Likely he knows something isn't right, you know it too. What else do you need? What benefit would be derived from him knowing? Best to you.

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My mother has always been aware something is” off” but refuses to admit it’s dementia ( literally screamed at the dr, told her she was a fool , every name in the book) . So instead she’s created a world of delusions that suits the situation, she can’t find something because someone stole it, she can’t figure out how to unlock the door because someone broke it etc etc etc. I don’t know how much of that is due to her narcissism ( she’s always lied about literally everything) and how much I’d her fear since she also refuses to accept my stepfather had Alzheimer’s even though it was obvious to anyone else by the time he died.
I don’t know that you can change what they perceive as reality. That’s hard enough to do with a more functional brain much less a damaged one.

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My mother had dementia as well. No-one in the family would acknowledge it, instead simply covering up, and in the end, blaming me for any discrepancies that occurred in finances, orders, failure to pay bills, etc. I finally had to walk away from it all, it was so toxic. In the end, after she died, my sister accused me of like property taxes, etc stealing from my parents. My father had never been responsible with money, and Mom always did the finances. When they would no longer let me assist he ran them into the ground. I lived more than 1800 miles away so it would be pretty hard for me to steal from them. No access to check books, account etc. My sister had power of attorney for the final two years before Mom's death. She even took me to court to sue me for elder abuse. She did not prevail, and the Judge was appalled at my sister's accusations, as they were unfounded and she could not support any of them. The craziest part of all of this is that my sister is a sitting judge herself. This was the first legal case she ever lost in 30+ years of being a lawyer. The saddest part is that to to this day 10 years later, she still believes that I stole from my parents, and she and my brother have not spoken to me since. My Mom was oblivious, and my Dad lived in denial that anything was wrong for years. Families are hard.

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I know that in the early stages some people are aware they have MCI or even dementia. I've read where they participate in testing, consult with experts, do research and plan their treatment and medical leave from work. They even post online to gain support from others who are affected by this terrible condition. They have recognized that they have issues and are concerned about it. They sometimes share with their family members and friends. I like to hear from them, because, they provide so much helpful insight into what things are like.

And, then, there are some PWD who have had the condition for many years, but, they are still able to type long and detailed accounts of their daily life. Of course, that's always a mystery to me and I wonder how that is possible. Does anyone know if it is possible for a person who suffers with dementia to the point that they are not able to live alone, to be able to recall many details about the previous day, week, month, year, etc. and are able to describe it in writing with perfect grammar and punctuation? I'm really curious, because, I have no way of confirming if they are truly dementia patients. I do find it confusing, but, have no clue why someone would feign that condition. (I am NOT referring to anyone who posts on this site.)

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Tiger - in a *way* the drugs would be responsible for our mental decline, in that they enable many more of us to reach the advanced old age at which mental decline becomes so common. Without the drugs our mean lifespan would be greatly reduced and we wouldn't have those years and years of having our body chemistry altered. No hearing loss, no persistent cough, no kidney damage, no crippling osteoarthritis or muscle cramps - just think of all the advantages!

There's just the one problem...

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Yep, cud be! I'm just concerned cuz of the earlier onset of the cognitive symptoms, like folks in their 50's. Those folks had the newer 'statin' & bp drugs prescribed to them when they were 30ish. Not enough studies of that prob.

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Mostly, Mom didn't know, which was a blessing. Be grateful if your loved one's not aware of it. When Mom knew something was wrong she'd beg me to fix it, to help her. Ripped my heart out.

I never lied to her. I would gently tell her she had dementia, what it was, nothing could fix it, but we'd all help her through it. She would only nod her head in resignation. The only good thing is she'd forget momentarily.

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No pushing. It does not help and will be forgotten anyway. My mom always knew her memory was getting really bad from the beginning, but wanted to be independent anyway. Eventually she accepted help and gave up the things she realized she could not do and even now she knows she has a very bad memory. But some people are not aware of it and unless the issues cause dangerous situations it's best to go along or divert.

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It scares us all, the prospect of dementia... (& Lately the medical news is all about altziemers/dimentia.) But I strongly suspect that the drugs Drs hav been giving us (for bp, cholesterol, ect) are the main reason for our mental decline. Years & years of altering our bodies chemistry..(Many scientific articles point to the connection), yet Big Pharma rules the world, so nothing gets disclosed or improved. And now, drug makers can profit off of 'altzeimers' cures...& we dive right in to gobble up their new pills. Don't worry that people can barely afford groceries. It's obscene, just sayin'.

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The biggest problem is Type 2 diabetes. And we bring g that on ourselves with too exercise, too much stress, and horrible dietary habits. The medical community keeps trying to solve a problem with a pill instead of making us change the way we live. We created the problem and want a quick fix...we are getting what we deserve and what we asked for.

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My husband used to wake up every morning and say, “I thought today would be different. I thought I would be okay again.” It was heartbreaking. He’s now in a later stage and still seems to know he can’t think clearly and it causes anxiety. Others in his memory care facility will comment I can’t remember things anymore or my brain doesn’t work good. I’ve read that not knowing you have cognitive decline is part of the disease. I also think it’s a blessing as I see the angst those who are aware go through.

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Sometimes they're aware, the answer truly = it depends on the situation and brain

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My MIL is very aware of her speech problem. When trying to communicate she will often stop and say "oh, I can't talk", or "I need a brain". On the other hand sometimes she sees things that simply aren't there, such as last night when she saw a message from a relative on her bedroom ceiling. I think she really believed something was written there. So I guess some things she is aware of and others she is not.

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Not being aware is their blessing in this horrible disease. No point in trying to explain as they won’t remember and no reason to have them afraid. As the caregiver you being fully aware is the terrible burden you carry. You don't know specifically what’s next, but are aware it gets more difficult. Just do your best to make him feel safe and loved. My mother is the same with ALZ and is thankful she “has nothing wrong” with her. It’s how her broken brain gets through it I guess.

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Hello,
when a person with dementia doesn’t think they have a problem it’s called anosagnosia = loss of awareness

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In my albeit limited understanding of Anosognosia, it isn't so much that they are unaware as it is that they are in denial. Anosognosia is often considered within the parameters of mental illness and often displays in conditions such as schizophrenia and bipolar disorder. For example, my mother has had memory loss issues for several years now, but has just recently (within the past few months actually) reached the point where she not only isn't aware she forgets things, she doesn't seem concerned about it when she does. I guess I was the one more in denial of her diagnosis of ALZ because I resisted it. However, in researching her symptoms I came across this page from Science Daily that helped me understand the process better. https://www.sciencedaily.com/releases/2017/10/171010133917.htm

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When we eventually realized my MIL had significant short-term memory loss when I asked the social worker how it was that it took us so long to see it. She said there's something they call "apparent competency". My MIL knew something was not right with her but she would give very vague and general answers to questions. And since we didn't know any better, we accepted her answers. But if we asked her questions that required very specific answers (like on a cognitive test), she couldn't. Like, asking her what season it was and her looking out the window at the snow and being unable to answer correctly. It is a balancing act to know what to say and when to say it. Good advice from others on this thread. Blessings.

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Is the loved one your 69 year old husband?

That's on the young side: I wonder how complete the testing and diagnostics have been so far?

What led you to getting him investigated in the first place? Has he ever shown any concern on his own part?

As to whether to "push" him to understand - push is never going to be the right approach, but openness and taking opportunities to discuss and explore the subject with him would be. If you are still waiting for more information, it might be best to sit tight and go with the flow until you have a clearer picture of what he's dealing with.

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They go in and out of knowing and suspecting and being agitated by it, worried and fretful about the control slipping, worried that they do not perceive reality as others do. Do not push. It increases ten fold the agitation and fretfulness. Just gently repeat things you need to. Explain that there are some memory glitches and it is "normal" now, and will happen more; reassure that you will take care of everything.

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Good answer...

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Do they know they have memory/cognitive issues?

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