Two big topics: anosognosia and driving

Jeanne C.

Excellent post by @ButterflyWings discussing a couple of topics that are crucial in the early stages.

ButterflyWings Member Posts: 1,466

Hi to all new members posting here. Sharing two things here, that are intertwined. This is what I learned first hand in the last 6 years of dementia caregiving 24/7.

• Anosognosia is a real thing and it is best to learn the art of "fiblets" and workarounds. Imagine someone gaslighting you about things that do not fit your reality. You/we would be irritated at the very least. But with the dementias there also are challenges with judgment, emotion regulation, moods, perception, executive function/decision-making and more. So, the frustration, fear and anxiety — and fury, that your trying to reason with someone whose reasoner is broken can cause? Totally understandable and should be avoided at all costs. They can't help themselves. We can control our thoughts and approach, though.
• Driving is a huge issue in early stages as is financial mismanagement. I too, thought the biggest issue with driving was his potentially getting lost. That is due to the lack of awareness that dementia is more than just amnesia - memory loss. Turns out that is only 1 of the 7 "A's" of dementia. In addition to all the brain and behavior changes I rattled off above, there are also vision, hearing, and spatial issues, reflex and muscle control concerns and much more. This is because when the brain glitches, it can short out just about any function at any time. You really don't want someone behind the wheel of a heavy metal vehicle moving at high speeds, when this is the reality. It sounds like you have had 2 warning shots with his getting lost with police involvement and no clear explanation of what happened. Those are the "near misses" that you know about. Trust that there have been other signs. See the last article below.
• Reread Iris' and the other members' excellent comments - driving and anosognosia mean at some point you need to take the reins, and the keys. He will not perceive that he's impaired as you can see. And you will not be able to negotiate or convince him. Our PWD LOs who can sit and agree, then keep their word, are few and far between. Its brain disease after all, and not their fault at all but we really need to take it seriously. Quickly. Other peoples' lives are involved. You don't want to get sued for killing someone or their child. Sorry to be so blunt, but that is what is at stake. Families and friends MUST be responsible regarding driving and dementia. I disabled and then disappeared the car - short version of a long story.

Here are some helpful short articles for how to handle things — my best approach was "don't ask, don't tell".

https://alzconnected.org/home/leaving?allowTrusted=1&target=https%3A%2F%2Fwww.agingcare.com%2Farticles%2Fanosognosia-dementia-patients-cant-recognize-impairment-210090.htm

https://alzconnected.org/home/leaving?allowTrusted=1&target=https%3A%2F%2Fdailycaring.com%2F6-ways-to-help-someone-who-doesnt-know-theyre-ill-anosognosia-in-dementia%2F

https://alzconnected.org/home/leaving?allowTrusted=1&target=https%3A%2F%2Fwww.vha.ca%2F2021%2Fcompassionate-care-strategies-using-the-7-as-of-dementia%2F

https://alzconnected.org/home/leaving?allowTrusted=1&target=https%3A%2F%2Fnewsnetwork.mayoclinic.org%2Fdiscussion%2Falzheimers-and-dementia-when-to-stop-driving%2F