The Five A’s of Alzheimer’s

Alzheimer’s is a difficult disease—not just because it wreaks havoc on body, mind, and family, but because it’s ever-evolving. Today’s symptoms may be gone tomorrow, and tomorrow usually brings a brand-new challenge. But despite the shape-shifting, there are five common traits that show up in people with Alzheimer’s. These disabilities are known as the five A’s. Understanding them won’t cure dementia, but it can help prepare you for the twists and turns of Alzheimer’s. 

AMNESIA

Amnesia is memory loss that often begins with short-term memories; as dementia progresses, long-term memory loss also becomes noticeable. As memories deteriorate, so does the ability to absorb new information. Amnesia is not the same as the forgetfulness that comes with advanced age. For example, misplacing a wallet could be attributed to age-related memory loss. But putting that wallet in the freezer is probably amnesia.

How to Help 

People with amnesia aren’t being willfully forgetful and they aren’t necessarily hard of hearing—they simply can’t retain information. Speak slowly, clearly, and simply when communicating with someone struggling with this aspect of dementia.

APHASIA

Aphasia means difficulty communicating. It can affect the way a person with Alzheimer’s speaks and/or processes information. 

When speaking, aphasia may manifest as word substitution (calling a “bowl” a “cup,” for example) or word generalization (asking for “that thing” instead of “that magazine”). It can also show up as nonsense words, repeating the same sounds over and over, or mixing up sounds within a word. 

When receiving information, people experiencing aphasia may hear only part of what’s being communicated, answer incorrectly because they don’t understand, or simply nod to cover their confusion. They also may avoid crowded situations where sounds become overwhelming and indistinguishable. 

How to Help 

• Give your loved one a chance to respond even if it seems to be taking an inordinate amount of time. 

• Don’t say as much. Simplify your message. 

• Avoid vague questions. Use straightforward language with clear choices. 

DON’T SAY: What do you feel like doing today? 

DO SAY: Would you like to visit the library or go for a drive today? 

APRAXIA

Apraxia refers to a loss of motor skills that occurs because the person with Alzheimer’s forgets basic movements and activities—essentially, the brain and the muscles aren’t communicating. Apraxia commonly affects daily activities like bathing, dressing, walking, and eating. It can also affect speech. 

How to Help 

• Be very clear when providing instructions, breaking them down into small steps. 

• Avoid distractions. 

• You may need to demonstrate a task repeatedly before the person with apraxia can perform it. 

• Take a break to avoid distress for you and your loved one. 

• People with apraxia are at a higher risk of falling. Stay vigilant, and make sure the home is free of clutter and has grab bars for bathing and toileting. 

AGNOSIA

A particularly heartbreaking—and common—disability associated with Alzheimer’s is agnosia. Agnosia causes difficulty recognizing familiar objects, places, and people. For the loved one of someone with dementia, it can be devastating not to be remembered. For the person with agnosia, it can be embarrassing and disorienting. 

How to Help 

• Since the person affected is unable to connect objects to their usage, it can help to use gestures. So, instead of saying, “Brush your hair,” you might gesture to the brush and demonstrate your request. 

• Think ahead: Place shoes next to socks, the appropriate utensil in the hand, etc., to encourage correct usage. 

• Label common objects, rooms, and people in photographs. 

• Make sure your loved one always carries identification. 

ANOMIA

When a person with Alzheimer’s struggles to find the right word, it’s called anomia. Usually, they’ll know what the object is and what it’s used for but can’t come up with its label. 

How to Help 

Anomia can be frustrating for loved ones and caregivers. Try to remember that it will take longer for the person to communicate. 

With all the A’s of Alzheimer’s, patience is key. Your loved one isn’t intentionally forgetting things or struggling with activities. Their brain simply isn’t working the way it used to. All five disabilities are upsetting but they’re also part of the evolving journey of Alzheimer’s. Remember to stay calm—and reach out for help if you need it. 

At Tender Rose, we work to make every day a good day for people with dementia. If you need support, get in touch.