Empathy Loss during Dementia

As dementia progresses the affected person commonly loses the ability to read the emotions of another person. They also fail to understand how their own words or actions affect someone else and they may seem narcissistic. This often begins to happen very early in the symptoms, sometimes even before memory problems.

Seems everything is about them.

Empathy is defined as the ability to sense other people’s emotions, and to be able to imagine what someone else might be thinking or feeling. Person to person emotional communication requires that the brain process people’s facial expressions, body language and tone of voice as well as what they are saying. We do this unconsciously with every personal encounter. Actually, what we say isn’t as important as how we say it and how we physically demonstrate our feelings through all of the above.

As dementia damages the brain of a person with dementia, making these distinctions becomes difficult or impossible. Even if they could decipher what you are feeling they often have lost the cognitive reasoning to mentally figure it out or understand what to do about it.

I raised a son with high functioning Asperger’s and he had this same problem. He couldn’t read people’s emotions and even if you logically explained it to him, he didn’t always get it. This is a common trait of Asperger’s and Autism.

With dementia however, this is a result of the progression of damage to the brain’s processing of emotion. They also lose their emotional filters and can have sudden emotional meltdowns becoming combative or confrontational, saying and doing things that hurt the people caring for them. The filters dissolve and so does emotional restraint.

Emotionally they are like a ship tossed around in a storm without a rudder. Some people were always emotionally overbearing or volatile and it makes it harder for their family to believe this is the dementia and not their old self purposefully being hurtful. Regardless of their past self, the present version of this person with dementia does not have the ability or control to stem the tide of their emotions.

Remember, don’t take anything negative personally and always know it is the dementia speaking.


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