My husband and I sat and listened to the couple fight.
“I don’t have Alzheimer’s. That doctor’s a whack!” Jay* said.
“Yes, you do. Just like your mother.” Lana’s reply was terse.
“My mother never had Alzheimer’s. That’s a lie you like to tell.”
And on and on it went.
Did you know there is a name for what Jay is experiencing? It’s called anosognosia (“without knowledge of disease”). People experiencing anosognosia have no idea there is anything wrong with them. This not only happens with those suffering from Alzheimer’s, but also occurs with traumatic brain injury, brain tumors, stroke, and other types of dementia. As many as 81 percent of patients with Alzheimer’s experience some level of anosognosia. Sometimes it is selective and other times complete and it can affect their
Occasionally, people like Jay realize they are struggling, so they offer explanations: “I didn’t get enough sleep last night… having a bit of brain fog.” When they discover food burning on the stove, they insist it was just a mistake. The reaction is immediate and adamant: “I don’t need any help!”
But what happens when you, as a concerned family member or friend, realize how wrong they are? The more you suggest having a caregiver assist in the home, the more they push you away. Even the most complacent person can suddenly become aggressive and confrontational as they fear their independence is being taken away.
Recently, I received a phone call in the office from Lana. She was distraught. Jay was planning to walk down to a busy highway to rent a car. While she recognized that it was no longer safe for him to drive, Jay’s anosognosia prevented him from accepting the fact. If she wouldn’t give him the car keys, he’d just get a rental! Of course, that would not actually happen, but her immediate fear was his leaving the house and walking to the busy highway. We sent a caregiver to get there as quickly as possible to help divert a crisis. A few days later, Jay was placed in a memory care unit where he would be safe. It was heartbreaking, especially since he does not recognize his mental deficiencies.
Would have knowing about anosognosia helped Lana in dealing with her husband better? Perhaps the knowledge would have prevented her from insisting he had a problem, which only served to antagonize him and escalate the tension. Remaining calm in the face of Alzheimer’s is a tall order yet can go a long way in diffusing confrontations.