Saturday, April 19, 2014

Options For Elder Care: Anosognosia

Options For Elder Care: There is NOTHING Wrong with Me and I Don’t Need Help! (Tips for dealing with a loved one who deny they have an impairment)

 Anosognosia is not

denial, but the lack of knowing that an impairment, deficit, or illness

exists. It results from physical changes in brain cells most typically

in the right front side of the brain as well as in part of the lobes

directly just behind. Decreased self-awareness results from these brain

changes. To put it another way, “our right brain is wired to detect

anomalies and new information and incorporate these into our sense of

reality. When something happens to damage that part of the brain, the

left brain seeks to maintain continuity of belief, using denial,

rationalization, confabulation, and other tricks to keep one’s mental

model of the world intact” says neurologist Dr. V.S.  Ramachandran of

the New York Times.

The most frequent problem we see in our Geriatric Care Management

Practice is the person is no longer able to perform their activities of

daily living (ADLs) functions such as cooking, bathing, dressing,

financial management, taking medications, or remembering appointments.

When confronted, there is vehement denial anything is “wrong” and may

react with anger and defensiveness.


  1. Ramachandran , v.s. (1995). Anosognosia in parietal lobe syndrome. Consciousness and Cognition, 4(1)

  2. Ott, B.R.Lafleche, G.,Wheliham, W.M., Burongiorno, G.W., Albert,

    M.S. % Fogel, B.S. (1996). Impaired awareness of deficits in Alzheimer

    disease. Alzheimer Disease and Associated Disorders, 10 (2).

  3. Xavier Amador, Anna-Lica, and Ph.D. Johanson, I am Not Sick I Don’t Need Help!Publisher: Vida Pr

  4. Antoine C1, Antoine P, Guermonprez P, Frigard B., Awareness of deficits and anosognosia in Alzheimer's disease.  Encephale. 2004 Nov-Dec; 30(6):570-7