Apraxia and Dementia: Important Things to Know

Introduction

One of the most common cognitive issues that is seen with dementia is apraxia or the inability of the body to respond to messages that are normally sent from the brain, such as the brain telling the hand to move a fork to the mouth. Generally, a person with apraxia as a result of dementia will not be able to connect the two ideas until someone physically moves the fork to the person's mouth.

Dementia has many different symptoms, including those that are cognitive as well as those that are psychiatric. Understanding the difference between the symptoms can help yield the right type of care. If someone is seeking psychiatric help for cognitive disorders, for example, the right treatment will not be provided, and the desired result will not be achieved.

Types of Apraxia

There are many different types of apraxia the dementia patient can display, but the most common include:

• Dressing apraxia - Patients that are unable to process the command to get dressed
• Ideamotor apraxia - Patients are unable to mimic an action, such as brushing their teeth or lighting a match when prompted to do so
• Ideational apraxia - Patients lose the idea behind what a specific tool or object used to do for them, such as the above example with the fork

The Importance of Understanding Apraxia

There is often misunderstanding and miscommunication when it comes to apraxia and the dementia patient, which leads to incorrect diagnosis and treatment. There are a variety of ways that obtaining the correct diagnosis can help someone suffering from dementia and his or her caregiver(s), including:

• Proper education about the diagnosis can instruct in what to expect and thus avoid frustration. When a loved one forgets how to use utensils or how to get dressed, it can be fundamentally frustrating for everyone involved unless they understand why it is happening.
• Understanding the difficulties, a loved one has and the reasons for them can help family members plan to arrange appropriate help for the elderly loved one suffering from apraxia. For example, if they know that the person can no longer handle getting dressed, family caregivers might consider in-home care so that they feel assured that the loved one's basic needs are met on a daily basis, even when they cannot be with the person at all times.
• Avoiding the use of unnecessary medication can help the loved one's prognosis. Unnecessary use of anti-psychotic medications can lead to a variety of other health issues that can adversely affect an elderly loved one's future quality of life.

How to Deal with Apraxia

It can be very frustrating to deal with a loved one's sudden inability to perform basic tasks, but since those are the circumstances of apraxia, it is best to understand how to handle the situation as it is.

A top priority should be creating a calm environment. This might take some hard work and could even include some counseling or education in how to achieve it. The benefit of getting fully educated on the different types of apraxia a loved one is experiencing is that family members/caregivers will be able to be more patient and understanding of the loved one's needs.

Ample time and patience will be needed in order to help an elderly loved one suffering from apraxia. For example, teaching such a person just once how to get dressed is not going to work. The person will have to be shown this basic task again and again, much like a small child. The elderly person still may not understand what he or she needs to do, so any caregiver dealing with someone with apraxia is going to need stores of patience. If the person simply does not understand, sometimes it is best to set aside the task and wait to start on it another time. Repeating the task over and over again in a short amount of time without a positive response or any success will only serve to frustrate everyone involved and could lead to emotional reactions.

A great way to reduce frustration levels is to find alternative ways to do certain tasks. If doing a task one way is too hard for someone to understand, trying it an alternative way might work. The Internet is a great resource for finding alternative ways to do things, like tying shoes or even putting on a shirt. Specific orders may not make sense to a person with apraxia, but breaking those orders down into manageable parts might work.

Dementia on its own is a difficult disease to deal with, but when apraxia is added to it, the frustration and devastation can escalate rapidly. It is to family members' benefits to get educated on how to handle the different types of apraxia affecting an elderly loved one. If it is unclear exactly what type pf apraxia an elderly loved one is suffering from, family members/caregivers do well to jot down a list of all the difficulties encountered on a daily basis and to discuss this list with a doctor. Finding the exact diagnosis of the difficulties can make a big difference in both qualities of care and quality of life.

Sources

Chandra, S. R., Issac, T. G., Abbas, M.M. (2015). Apraxias in Neurodegenerative Dementias. Indian Journal of Psychological Medicine, Jan.-March, 37(1): 42-47. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4341309/. Accessed on August 22, 2016.

U.S. National Library of Medicine. (July 27, 2014). Apraxia. Medline Plus. Retrieved from https://medlineplus.gov/ency/article/007472.htm. Accessed on August 22, 2016.