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Seven A’s of DementiaCaregiving

Dementias such as Alzheimer’s disease are neurological disorders, which means they affect the individual’s mind and shape their perception throughout the memory loss journey. Those of us with normally functioning brains can find it confusing and frustrating when dealing with someone in cognitive decline because, simply put, their brains aren’t working the same way as ours.

“Dementia isn’t limited to just one area of the brain, so the changes end up affecting all aspects of a person’s mind and body,” says Andrea Campisi, Marketing and Admissions Director of The Reutlinger Community, a Continuing Care Retirement Community in Danville, CA. “This can be confusing and alarming to family caregivers, who may see their loved one experience changes suddenly overnight. Unfortunately, there’s no one way the disease progresses, so the changes can seem rapid and disjointed.”

To help understand how your loved one is experiencing the world as the disease progresses, the Memory Care community uses the seven A’s of dementia.

“The seven A’s are used as shorthand to help caregivers in particular remember what areas of the brain are being affected by dementia,” says Andrea. “Each A represents an effect that happens due to damage in a particular part of the brain.”


Anosognosia is a medical term that describes someone with dementia being unaware of their condition. This symptom is caused by changes or damage to the frontal lobe of the brain, which is responsible for self-image, insight and reflection.

To those of us with normally functioning brains, it appears that the person is in complete denial about the situation. However, to the individual, they really cannot understand that they are ill due to the changes their brain is experiencing. Someone with anosognosia will stubbornly insist that everything is fine and they have no issues. They may exhibit poor judgement, be unaware of how their actions make other people feel, or be physically aggressive as they try to resist any form of care.


Memory loss is the hallmark of dementia, and manifests first with the loss of short-term memories. This occurs when the temporal lobe is damaged. Without short-term memory, a person with dementia is effectively unable to learn anything new. Someone with amnesia due to dementia will be unable to remember what happened that morning, but can easily reflect on something that happened in their childhood. They also can become more anxious and overwhelmed, since they’re unable to process the new information, and may continually repeat questions or comments. They can also start to not recognize friends and family members, or confuse them with people from their past.


When dementia attacks the parts of the brain that control language, the individual experiences aphasia, or the loss of their language skills. While the person with dementia can generally still comprehend nonverbal communication, he or she can lose the ability to express themselves verbally, may find it hard to understand what’s said to them or have difficulty reading or writing. In early stages of aphasia, the individual may substitute words (being unable to find the right one), or revert to a native language they spoke as a child.


Agnosia is defined as the loss of recognition – specifically, the person with dementia loses the ability to recognize people, objects and other things through their senses. Smell, touch, taste, sound and sight no longer trigger the appropriate responses in their brain. This manifests in confusion, such as thinking that a close friend or family member is an impostor, or not being able to recognize themselves in a mirror and thinking their reflection is a stranger. Unwanted behaviors, such as inappropriate sexual behavior, can arise from agnosia. Individuals can also forget how to use everyday objects, such as a hairbrush, fork or toilet.


Dementias such as Alzheimer’s disease eventually affects the motor functions of an individual, making it difficult for them to move purposefully, or understand how to execute a series of tasks. Someone with apraxia can have trouble dressing themselves, become distracted easily while doing tasks and leave them undone, have a hard time with push-button items like phones or television remotes or become frustrated when faced with a task that requires multiple steps without clear, step-by-step directions.

Altered perceptions.

This “a” specifically relates to altered physical perceptions, such as depth perception. This affects how a person reacts to stimuli around them and affects the way they move, walk and sit. This can also result in visual distortion, which causes the individual to misinterpret the environment around them and cause fear. Someone with altered perceptions may be afraid of bathing, because they may think the water is very deep and there is a risk of drowning. Shadows may appear as holes in the floor, and chairs or other objects may appear as people.


Over time, someone with dementia will lose the ability to initiate activity or conversation. This can appear to a caregiver as depression and an act of withdrawing. It’s important to note that even if the individual can’t initiate conversations, they are able to participate if someone engages with him or her (that’s not the case with someone with dementia who also has depression). Someone with apathy will spend much of the day in silence, but will react if someone speaks to them or calls their name. While he or she may lose interest in beginning or staying involved in activities, it doesn’t mean that he or she doesn’t want to be a part of the activity – it’s just beyond their ability.

Not every person with dementia will experience all of the seven A’s, but it is important for caregivers to be aware of them so they can take steps to manage and work around the behaviors. By paying attention to your loved one’s moods and actions and reacting appropriately, you can help navigate the A’s and provide a happy, safe, high quality of life for your loved one with dementia.

For more information about dementia caregiving, or to learn more about our community, mission and values, please contact us at 925-272-0261.

Premier Senior Living, Dedicated Care

The Reutlinger Community’s mission is to provide high quality health care and social support services in a life-enhancing and stimulating environment with a commitment to Jewish values.

Offering Assisted Living, Enhanced Assisted Living, Memory Care, Skilled Nursing and Rehabilitation, The Reutlinger Community provides a continuum of care that allows seniors to live a life-enhancing and stimulating environment. Located in Danville, California, The Reutlinger Community’s newly renovated, 110,000 square foot community combines the comfort and familiarity of home with seasoned senior care and skilled nursing specialists to suit any senior’s needs, allowing them to live the life they choose with freedom and security.

Because we specialize in a continuum of care, our residents never need to worry about leaving the community they call home or wonder what will happen when they need some more care. Residents and families alike can have peace of mind knowing that there are full-time licensed nurses available, along with activity coordinators, social workers, caregivers, a concierge and Rabbi who focus solely on helping each resident thrive. Even better, our services and amenities are equal to those of a state-of-the-art resort. This is the lifestyle and care that your loved one deserves.

At The Reutlinger Community, seniors have numerous opportunities to engage in award-winning programs that are designed to engage the mind, renew the spirit and provide opportunities to meet new people and learn something new. Whether residents are enjoying our art program and museum, listening to a lecture or educational program or attending spiritual programming and our wide range of activities, there’s something for each resident to love. Participate as much or as little as you like, the choice is all yours.

For more information or to schedule a personal tour, contact us today.

Author: sageage