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New to this...Not diagnosed yet...Scared to find out
Unforgiven
Posted: Sunday, October 4, 2015 1:32 PM
Joined: 1/28/2013
Posts: 2659


Can I add that the visual anosognosia can depend on the surroundings? For instance, I am currently doing home renivation, which not only means emptying bookshelves and cabinets and leaving them out on normally clear surfaces, but it means many tools and materials on those surfaces too. I am constantly losing track of the tool I need at the moment, because I set it down in the last place I was working, and often can't pick it out among all the clutter. When I find it, I had looked in that spot several times already, and I give my head a good smack.

This is why CGs are told to provide a PWD with an uncluttered environment. I think it's a good idea for everyone, and it's why I became a neat freak. It isn't just about how things look. It's about how well you function.

It is such a wonderful feeling not to worry about my car keys, because (1) there is a standard spot for them and (2) they will be readily visible on the pristine surface where I absentmindedly left them. If only I could get everyone else in the household to cooperate.

The_Sun_Still_Rises
Posted: Sunday, October 4, 2015 3:55 PM
Joined: 7/24/2015
Posts: 3020


Unforgiven wrote:
This is why CGs are told to provide a PWD with an uncluttered environment. I think it's a good idea for everyone, and it's why I became a neat freak. It isn't just about how things look. It's about how well you function.


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I am not sure that is why others told you to provide an uncluttered environment, but it is true it sure does help you find things.

In the later stages of dementia (5+) uncluttered, calm, quiet, low-energy, low-key, plain environments are provided to reduce cognitive load. In the later stages of dementia, literally every task becomes a huge cognitive load in itself - visually processing the surface of the floor, and sorting out and coordinating legs in order to walk across the floor is an all encompassing task...add to that trying to remember you are heading to the bathroom and where you have to go to get there. If you add to that equation, people touching you, words they are saying at you, things moving in the back ground like children or dogs or a TV, and noise in the background, it quickly becomes too much and the person with dementia becomes sensory and cognitively overloaded. This overload is very eloquently expressed as "agitation."

When CG's do not realize this, they often unwittingly make the problem worse...they touch more, firmer, talk louder, and weirder toned, emotion becomes part of the scene...and it forces the person with dementia into a hard-wired fight or flight response. They have no way to say stop...other than all the popularly talked about behavior issues, that is their word for "stop now."

This is commonly referred to as agitation...and is often worse in the evenings. When CG's do not understand how they are causing, contributing to, and making this problem worse, the person with dementia is often blamed and labeled a behavior problem. If the situation is not corrected (and the only one, of course, who can do any adjusting and correcting here is the CG (and we all know they are unlikely to ever see themselves as cause in the matter), but if the situation is not corrected, the person will likely be drugged with inappropriate drugs that hasten their death and reduce the quality of their remaining life.

The reason we provide calm, peaceful, uncluttered, plain, low-energy environments is lessen the cognitive load, to lessen the chance of agitation, to reduce sundowning, and allow for a better quality of life for both the person with dementia and their CG.

Although no one has said this on here before, when provided a calm, peaceful, clutter-free, low-energy environment, people with dementia in the later stages are able to remain in their best functional state...and function at the highest level available to them. While that has obvious benefit for the person in later stages, the benefit to CG's is the highest ability for them to stay functioning in their tasks.

Everything short of that calm, peaceful, uncluttered environment puts people in the later stages into literal survival mode...others here have been quite open about talking about that on here.

That is why you were told to provide an uncluttered environment. That said, with your mom...who knows, that might be different since there is likely an emotional issue linked to stuff. It might be wishful thinking, but I'd like to imagine your mom would be very happy in a super clean uncluttered environment...either way, I wish that for you two anyways.

Hope that helps clarify.


Iris L.
Posted: Sunday, October 4, 2015 8:49 PM
Joined: 12/15/2011
Posts: 18519


Agnosia means you can no longer recognize things through your senses: sight, sound, taste, touch, and smell. You might not be able to sort out what you see or hear. You might have trouble recognizing familiar people. Your safety may be at risk if this part of the brain is affected because you might confuse objects and what they are used for.



Agnosia is more than not locating an item in a pile of other items. It is not recognizing at item for what it is. For example, a person may not locate some keys in a pile, even though they are there. A person with agnosia may not recognize a key as a key.

One of the tests I do for myself is to attempt to identify items by touch with my eyes closed. This is a great exercise for me.

Iris L.

llee08032
Posted: Monday, October 5, 2015 7:20 AM
Joined: 5/20/2014
Posts: 4408


Ilee, the ophthalmologist has determined that your eyes see well. It is that your brain does not interpret the images correctly.

Iris L.

This is true Iris. Actually an opthalmologist first, and then the neurological opthalmologist. I am relieved that I don't have PCA or cortical basal dengenerative disease (CBD). I think the CBD is the worst because the progression is fast.

Unforgiven
Posted: Monday, October 5, 2015 2:49 PM
Joined: 1/28/2013
Posts: 2659


Agnosia means you can no longer recognize things through your senses: sight, sound, taste, touch, and smell. You might not be able to sort out what you see or hear. You might have trouble recognizing familiar people. Your safety may be at risk if this part of the brain is affected because you might confuse objects and what they are used for.



Agnosia is more than not locating an item in a pile of other items. It is not recognizing at item for what it is. For example, a person may not locate some keys in a pile, even though they are there. A person with agnosia may not recognize a key as a key.

One of the tests I do for myself is to attempt to identify items by touch with my eyes closed. This is a great exercise for me.

Iris L.
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Iris, I'm not sure what to call the phenomenon of having looked directly at an object several times and not seen it. All I know is that I'm familiar with it, and it seems to be getting worse the older I get. I think that visual hyperstimulation lowers cognition in everybody, which is why I learned to become organized two decades ago, and why I gried my best to teach my mother new and better habits while she was still capable. I don't know if she simply wasn't capable by the time my father died and we finally tried to declutter, or whether there was some deeper emotional need for the chaos even back then.

At any rate, I had certain suggestion for work-arounds, like opening the mail in the home office and putting important mail like bills into the proper pigeonhole then and there. She persisted in opening her mail in her dining room or her bedroom, and putting it in horizontal piles, which is a recipe for losing unpaid bills.

I encouraged her to develop the automatic habit of putting her credit card back in the wallet slot, rather than in a pocket to deal with later. Same with the car and housekeys --on a hook right near the dood. Failing that, to declutter her household surfaces so that things randomly set down would be instantly visible. I failed at getting her to do it.

I think that everyone needs all the cognitive ability they have available at any stage in life, and that good habit patterns (Best Practices) should be locked in early in life.

I discovered the mood elevating properties of a bare surface all on my own. With my mother, I still have to fight her tendency to add way too many things. She thinks I'm being ridiculous.The memory of cleaning out that penultimate hoard in her IL apartment will never leave me.

jess1992
Posted: Monday, October 12, 2015 1:39 PM
Joined: 10/11/2015
Posts: 32


It is very scary I didn't know myself for a long time but finding out is important so you know the right things to do for yourself this site is great I only just started but connecting with people who understand your fears will help
Iris L.
Posted: Monday, October 12, 2015 9:10 PM
Joined: 12/15/2011
Posts: 18519


Unforgiven wrote:
I don't know ..............or whether there was some deeper emotional need for the chaos even back then.






I just posted about apathy and abulia on the thread about my experience with the stove. I also posted about "la belle indifference." I know these applied to me as the clutter and piles were increasing. I saw the clutter and piles, and knew this was bad, but I was unconcerned (apathetic) and could not make a decision to make things better (abulia).

For a long time, I wasted time with psychologists who tried to project some deep psychological pathology onto me. But I have discovered that apathy and abulia are features of cognitive impairment and early dementia. So, I finally have an explanation for what I was, and still am experiencing.

apathy--don't care
abulia--can't make a decision



Unforgiven, no matter what you said to your mom, it would not have gotten through. She had a "mental block." People mock that term, but that is what she had in lay terms. There is no way you could have gotten through, if she were in early dementia.

One of the things that has helped me a great deal is being on medication. Medication and reading books and internet sites and communicating with you, Unforgiven, and others dealing with clutter on this board.

I am still waiting for the mood elevation effect of bare surfaces. My balconies are still bare. I do appreciate the bareness there.

Iris L.







Iris L.
Posted: Monday, October 12, 2015 9:22 PM
Joined: 12/15/2011
Posts: 18519




At any rate, I had certain suggestion for work-arounds, like opening the mail in the home office and putting important mail like bills into the proper pigeonhole then and there. She persisted in opening her mail in her dining room or her bedroom, and putting it in horizontal piles, which is a recipe for losing unpaid bills.





One of the reasons I lost confidence in geriatric care managers is because I had a gcm attempt to help me with my mail. She had some scheme dreamed up. I could not tell you today what she wanted me to do. This was in the early days of using Exelon patch, so I was not where I am today, meaning I was much more cognitively impaired.

What she should have told me to do, and what I am doing now, is to put ALL of my mail and anything that I bring into the house, such as lab reports from the doctor's office, into a dishpan. I do try to separate the bills when they come. But if I do not separate them when they come in, I KNOW that they are in the dishpan, because that is where everything is, not scattered around in many piles, like before.

That gcm worked with seniors, but she had no idea how to help me. I was very disappointed, because I was counting on her.



If any caregiver or gcm reads this, and wants to help their LO, please suggest that they put everything into a dishpan. Then you both can go through the dishpan once a week or whenever you decide, to separate the bills from the other mail.

Do not overestimate our ability to perform, especially if the patient is not on memory medications. Patients have impairment in the area of executive functions, meaning they cannot execute the functions they need to do.

Iris L.