Elderly man consoling his wife in a sunny forest as an example of anosognosia

What is Anosognosia

March 3, 2023

When your loved ones won’t recognize something’s wrong

Anosognosia. You may never have heard of it. And we wouldn’t bat an eye if you had to look up how to pronounce it.

Imagine this scenario. You visit your parents one weekend and something strikes you that hasn’t before. Their health is obviously not as good as it once was. They aren’t getting around like they used to, the house is more of a mess. There may be an unexplained bruise or minor injury they seem unaware of or have no explanation for. And when you confront them about it, they look at you as if you have tinfoil growing out of your head.

Try as you might, you’re unable to convince them something is wrong. They might continue to deny that there is anything wrong. They might even become irate or irrational. They simply won’t acknowledge there is a problem with their health.

Here’s the thing: they simply might not be able to.

This is quite possibly a medical condition, and it might be more common than you would think.

They might be suffering from anosognosia, which is an ailment that impedes the brain’s ability to properly perceive their self-image. From normal function, to injury or illness, the brain is supposed to keep an eye on changes to your body, track progress of healing or alert you when something is wrong.

Anosognosia impedes the brain from doing its job and, thus, might be causing your loved one to be completely unaware that they are having health issues.

elderly man looking in the mirror

How common is anosognosia?

Anosognosia usually strikes people with mental conditions or degenerative disease, such as schizophrenia, bi-polar disorder and Alzheimer’s disease or dementia. In fact, according to Cleveland Clinic, it affects more than 80% of people with Alzheimer’s disease and somewhere between 10-18% of people who have one-sided paralysis after a stroke.

When you consider that just over 10% of adults 65 and older have Alzheimer’s, according to the Alzheimer’s Association, the picture of why this scenario is common becomes clearer.

daughter consoling her mother who at a table with coffee and cookies as a way to exhibit an example of anosognosia

What are the symptoms of anosognosia?

The symptoms of anosognosia are tied into a person not being able to recognize that there is a problem with their health. Symptoms of anosognosia are going to be tied to other ailments that a loved one will not acknowledge.

If you’re noticing the following as identifiers of health problems, but they are unable to connect their perception to what is really happening, it might be a good idea to have a qualified nurse assess their situation.

    • Chronic symptoms, like coughing or wheezing
    • Recent hearing loss
    • Chest pains or shortness of breath
    • Bruises or minor injuries they can’t explain
    • Not taking, or improperly taking, their medication
    • An increased level of forgetfulness
    • Struggling to follow, or carry on a normal conversation
    • Increased fatigue or lack of energy

Really, any health condition, or mental condition that your loved one might be experiencing, yet not acknowledging might very well be a sign of anosognosia.

daughter with elderly father who looks confused and agitated

What to do if you suspect your loved one has anosognosia?

This is tricky, especially when dealing with aging parents or loved ones. Because they are medically unable to identify that there is a challenge with their health or mental well-being, you will have a difficult, if not impossible, time in convincing them that they need help.

Still, it is vital that you find a way to address this with them. The person suffering from anosognosia is quite possibly a danger to themselves and others. The danger to themselves starts with the inability to recognize health challenges and, if a serious injury occurs requiring immediate attention, the lack of perception could be fatal.

They may be at risk to others as their mental condition could make them easily upset and irritable and potentially escalate to violent behavior, especially if they perceive someone else to be a threat, no matter how well intentioned they may be. Unchecked dementia, for example, could lead household negligence that could jeopardize the safety of themselves or others.

Addressing this with them will not be an easy task. WebMD suggests you “…talk about their goals, such as keeping a job or living on their own. This might encourage them to meet with a mental health professional, even if they don’t think they need it for their health and well-being.

It is entirely possible you’ll need to find legal recourse to take action. The goal is their safety and well-being. You will want to check with the laws in your area on what options you might have. Or, find a professional who can be an advocate and liaison for you and your family.

In any event, recognizing when they are unable to recognize their health challenges, and having an understanding as to why, will allow you to be more compassionate to their situation and how you can best help.

In the end, it’s all about making sure they get the medical care they need.