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What to look for?

Insight (Others/Environment) | Common Signs

  • Does not notice changes in people or things
  • Does not recognize or understand the feelings of others
  • Does not recognize potential danger or hazards (e.g. hot stove, broken glass)
  • Does not understand why certain things happen despite an explanation
  • Is unable to tell the difference between what is real and not real (e.g. TV, dreams)
  • Seems unconcerned most of the time
  • Does not understand when a friend or relative passes away
  • Does not understand the appropriate way to act in public
  • Is not aware of how they are perceived by others
Insight (Others/Environment) | General Description

Alzheimer's disease affects a person's ability to understand the true nature of a situation. As a result they may be unaware of changes in people or things that they would have noticed before. For example, they may not be aware that a woman is pregnant, or that the arrangement of furniture has been changed. As well, the person you care for may be unaware of the feelings or emotions of others. For instance, the person you care for may unintentionally insult a friend and not realize that they hurt their friend's feelings. Their lack of insight may be particularly distressing for you in public. They may not realize they are behaving in an inappropriate or embarrassing way, and how that looks to others. For example, they may start to undress themselves in a public place. Often the safety of the person you care for is at risk because they do not recognize potential dangers or hazards. They may leave a stove or oven unattended and not realize that it could cause a fire. Sometimes the person you care for may not understand why a certain thing is happening, such as where the sound is coming from when the telephone rings. Even after they are told, they still may forget and become confused again.

Lack of insight and losses of the ability to empathize with others is a defining symptom in the diagnosis of Frontotemporal dementia . People who were normally emotionally sensitive may appear to be selfish and unfeeling. It can be helpful if the caregiver decreases expectations of emotional warmth and support from the patient and instead has these needs met through friends, family and social networks. Problems with insight are also common in Lewy body dementia, vascular dementia and Parkinson's disease dementia.

The first step in taking a more active role in symptom management is understanding how a symptom is affecting everyday life; the next step is communicating this knowledge to the care planning team and family members. SymptomGuideTM is designed with these goals in mind.

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See Also:
Symptom Library > Thinking & Judgment > Comprehension/ Understanding
Symptom Library > Behaviour > Inappropriate Language and Behaviour
Symptom Library > Thinking & Judgment > Unsafe Actions
Symptom Library > Behaviour > Delusions and Paranoia
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Last updated January 13, 2019
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