It has been quite challenging since my mom has returned home. She goes from happy to upset in a matter of minutes. She complains she feels like a ‘prisoner in her own home.’ The care partner, Ace, gives her as much independence as he can while keeping her safe, but my mom still thinks she doesn’t need him. She has poor insight into her disease and lacks the ability to see and understand the reality of her situation. It just breaks my heart to see her so upset. I knew it would take time for her to acclimate living at home, however, I can’t help but wonder if she will ever fully accept the care she needs.

Lack of insight is a common symptom that happens with Alzheimer’s Disease and other progressive dementias. It is characterized by a person’s inability to recognize changes happening, nor the need for assistance. This loss of awareness is directly related to damage to the brain’s prefrontal cortex. Lack of insight is often confused with denial. A person can have a lack of insight and be in denial at the same time, but denial is not directly related to the deterioration of the brain. Rather, it is a psychological, often subconscious coping mechanism used to manage the stress, fear, worry, and embarrassment that often accompanies the disease. A person in denial may accept their diagnosis over time as they allow themselves to open up and share their fears and concerns with others and seek professional support as needed.