caregiverscarereceivers4dementia:

Yikes! I just learned that there are 4 “A’s” associated with Alzheimer’s. Amnesia, which everyone is familiar with, is of course the memory loss. But as I keep saying, Alzheimer’sis about so much more than memory and these other A’s seem to reinforce thatidea. I had never heard of these terms before (other than amnesia) so they were
certainly new to me.

Agnosia, is when a person can’t quite recognize what an item
is for or is unable to recognize it at all. For example, Laura was helping me
put up some dishes and she held up a spatula and asked “where does this go?”
Glancing over, I said, “top drawer, right of the stove.” Probably too many
words all at once, but she couldn’t get past the stove part.  She started to say to herself, “stove, stove,
stove” as she did a 360 in the middle of the kitchen.  I realized that she either didn’t see the
stove or if she did, she didn’t recognize it and so I pointed to the drawer and
said, “it goes right there – in that drawer.” But she was hung up now on
finding the stove and she kept looking for it. I had to finally touch the stove
and say “here is the stove and the spatula goes here” pointing to the correct
drawer. She muttered a quick “of course, what was I thinking?” and moved away,
but I could tell that she was both a little embarrassed and frustrated with
herself over the incident.

Aphasia is the inability to use speech correctly.  Laura is frequently using general
descriptions now to identify an object as opposed to its name. This makes for a
dangerous game of charades, because I find that I must bite my tongue to keep
from giving her silly answers or get animated when she is trying to tell me
something. The last thing she needs is for me to interrupt her train of
thought. I have to pat myself on my back because I am getting pretty good at
deciphering her descriptions. Her speech is often halting, with many starts and stops and a lot of misdirection. “What are
you looking for Honey?” is a fairly common question these days.  “It was right here… you know, the pink one
with…store… makeup… before… it….’ That was it; but it was enough. I was lucky
that she used two fairly key words in there to help me out: Pink and make-up. That
meant she was looking for the pink case where she keeps most of her makeup.
Sometimes I’m not so lucky.

The last ‘A’ is Apraxia. It is when there is a loss of
motor coordination. Laura has trouble now often doing simple tasks such as
buttoning her blouse or signing her name. It’s like she knows what she wants
to do, but can’t get her hands or fingers to cooperate. Sometimes she may reach
for something but miss it entirely or on the other extreme, hit it with her
hand.

Unfortunately Laura has her ticket punched for all of these,
and it is my job to see that she keeps her dignity by not calling attention to
them. Like most other symptoms of Alzheimer’s these come and go and vary in
degree of severity when they are around.  Sometimes I marvel in that she can put on a necklace
that has a tiny, tiny clasp. Other times, she calls for help in tying a bow or
is incapable of turning the knob to turn on a lamp.

All of the A’s are bad but we’ll somehow work through them
all, but the one that scares me the most is Agnosia. I’m dreading the day that she not only forgets what the stove is; but forgets who I am
as well.