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The Eight A's of Dementia - the Why's behind different behaviours
HowDoYouDeal
Posted: Saturday, July 11, 2020 1:30 PM
Joined: 2/17/2019
Posts: 380


Example: Please identify the symptoms of dementia Mrs. Adonis presents with.

 • Anosognosia: does not recognize she has cognitive problems and wants to go home to her village. 

• Amnesia: forgets she has eaten, doesn’t recognize her surroundings.

 • Aphasia: loss of her second language English, difficulty having a simple conversation in Greek. 

• Attentional Deficit: wanders away from the music she enjoys. 

• Agnosia: misidentifies her daughter as her mother.

 • Apathy: states she is hungry but sits at the table until someone gets her started. 

• Apraxia: may not remember how to use the spoon to feed herself; no longer able to use a fork and knife.

 • Altered Perceptions: auditory misperception of the loud noise in the dining room. 

Case Study- Mrs Adonis Mrs. Adonis is a new resident on your unit.

 She has had a diagnosis of Alzheimer Disease for over 6 years. She speaks only her native language now, but staff who speak Greek tell you it is difficult to have even a simple conversation with her in Greek.

 She often motions to staff that she is hungry even though she has just eaten her meal. 

Her family has arranged for CDs of Greek music to be available for staff to play for Mrs. Adonis, but she wanders away from the lounge or her room where it is being played, even though she initially appears to enjoy it. 

Mrs. Adonis’ daughter approaches you today very distressed that her mother is calling her “Mother”, insisting she take her home to her village. 

At lunch, the daughter also comments that her mother says she is hungry; however she will sit in front of her meal until someone picks up her spoon, places it in her hand properly and helps her start eating. 

Later in the day, a tray of glasses is accidentally dropped on the floor, making a loud noise, and Mrs. A. quickly crawls under the table. Her daughter wonders if her mother thought it was a bomb like she had experienced during WWll. 

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Found this resources from 2009. https://www.champlainhealthline.ca/healthlibrary_docs/DementiaPrimer.pdf

  Amnesia– loss of memory (sensory memory, long-term memory, short-term memory, habitual memory) 

• The person may forget and not remember later, especially things that happened more recently

 • Last thing learned is first thing lost 

• Will ask/repeat same questions/ comments 

Example: Mr Jessup accuses his roommate of stealing his glasses, when Joe himself had placed the glasses in the drawer of his night table the day before.

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Agnosia - loss of recognition

• Loss of recognition crosses all senses (smell, taste, vision, touch and hearing) - the person has trouble understanding the meaning of what is seen, heard, smelled, touched, and tasted

 • The person may not recognize familiar faces – the person losses recognition of people in the order that they last came into his/her life

 Example: Mrs Agnew becomes frightened when she sees her reflection in the mirror, thinking an old lady is staring back at her.

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Apraxia – loss of purposeful movement :

Example: Miss Rogers is seen wearing her blouse over her pajama top at breakfast. 

• The person loses the ability to plan, sequence and carry out the steps of particular tasks even though the person is physically capable of performing the activity 

• Every task has an order and the person loses the ability to organize the sequence 

• Often a combination of not recognizing items and how to use them

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Apathy – loss of initiation

Anosognosia - no knowledge of the disease - meaning the person is unaware of the changes caused by the disease process.

Aphasia - loss of language

Altered perceptions - loss of perceptual acuteness:

• Changes in perception may cause a resident to misjudge depth. For example, he/she may feel like the bathtub has no bottom or those they are being lowered into a deep pool.