Understanding the 7 A’s of Dementia for Better Care

Posted by Bria Patterson on June 23, 2023

June is Alzheimer’s and Brain Awareness Month. It’s a time to show support for individuals and families who are impacted by Alzheimer’s and other brain diseases. 

According to the Alzheimer’s Association, as of 2023, about 6.5 million Americans aged 65 and older are living with Alzheimer’s. That number is expected to increase as more Americans continue to get older in the coming years.

The National Institute on Aging states Alzheimer’s is a form of dementia. Dementia is considered the loss of cognitive functioning that interferes with a person’s daily life. Alzheimer’s causes the brain to shrink and brain cells to eventually die. At this time there is no cure, but there are studies being done, as well as medicines to help slow its progression and improve symptoms. 


The 7 A’s of Dementia 

 If you are a caretaker or know someone with dementia, it can be hard to comprehend those symptoms and how they view the world. Learning the 7 A’s of dementia can provide a better understanding.  

According to The Visiting Homemakers Association (VHA Home Healthcare), the 7 A’s include anosognosia, amnesia, aphasia, agnosia, apraxia, altered perception and apathy. 


1. Anosognosia 


Anosognosia is brain damage that can make it hard for dementia patients to recognize their impairment. VHA states it can be easily mistaken for denial, stubbornness or embarrassment. It can also make their behavior unpredictable. 

According to the VHA, some Care Strategies include:

  • Don’t try to convince your loved one that they have dementia and instead make changes to help them live safely.
  • Approach added support or care as an opportunity to do more of what they enjoy, instead of making it about chores around the house.

2. Amnesia  

Amnesia is memory loss that initially impacts short term memories, but eventually impacts long term memories as the disease progresses. The VHA says it’s usually the most noticeable sign of dementia and can cause a patient to feel overwhelmed. 

Some VHA Care Strategies include:

  • Speak slowly
  • Use short, simple sentences.
  • Be as patient as possible. If you’re asked the same question repeatedly, try your best to respond as if it’s the first time.
  • Use signs around the house for visual cues and display photos of family and friends.
  • Follow a daily schedule. 
  • 3. Aphasia 

Aphasia is impaired communication skills. It affects the ability to speak, understand language and read and write. This can make it hard to understand a patient with dementia. 

Some VHA Care Strategies include:

  • Speak slowly and clearly and give your loved one extra time to respond.
  • Use non-verbal communication including visual cues and gestures. 
  • Watch for non-verbal cues that your loved one is in pain or discomfort. 
  • 4. Agnosia 

Agnosia is the lack of ability to recognize objects or people. The VHA says examples of this could be a patient burning themselves with hot water, or eating something that is not food. 

VHA Care Strategies include: 

  • Always introduce yourself and anyone else providing direct care.
  • Demonstrate how an object is used before giving it to your loved one.
  • Label regularly used items around the house.
  • Keep dangerous items out of reach.
  • 5. Apraxia 

Apraxia is considered the loss of motor skills needed for movement. According to the VHA, these cognitive changes can cause dementia patients to say ‘no’ when they’re encouraged to do something. It’s not because they don’t want to, but because they forget how.

Some VHA Care Strategies include:

  • Encourage independence by breaking down tasks into small steps.   
  • Always minimize distractions when you are giving instructions.
  • Use adaptive clothing with Velcro instead of buttons or zippers.
  • Use assistive devices in the kitchen and bathroom.
  • If the task isn’t essential and your loved one can’t understand you, set it aside and try again later.
  • 6. Altered Perception

This can make someone living with dementia misinterpret their environment. This includes how high, long or near objects are. It can also cause paranoia and delusions. 

VHA Care Strategies include:

  • Ensure that your loved one has regular eye tests and that their prescription is correct.
  • Try to remember how your loved one may be seeing the world instead of trying to convince them that they are wrong.
  • Walk across a floor surface or place a clean foot in the tub to demonstrate the depth to reassure your loved one.

    7.  Apathy

    This can cause someone living with dementia to lose interest in what is happening around them. According to the VHA, this can lead to low emotional responses to events and may be harder to complete tasks. 

VHA Care Strategies include: 

  • Change the way you suggest activities. Instead of leading phrases with “Do you” say, “It’s time to…” or “Here are your…..”
  • Create habits and schedule activities. 
  • Do more of the things they enjoy. 

Not everyone with dementia experiences the 7A’s. Click here for more information on symptoms and the forms of dementia.