Can a person with dementia not know that they are sick?

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Love one says they feel fine but show a lot of behaviors that says dementia (ie) toilet paper fiasco.

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Yes, it is entirely possible for a person with dementia to not know that their behavior or memory are not normal. Or they may sense that something is wrong but use denial to cope with it. Or they may be fully aware that something is not right, and even ask "what's wrong with me?"

Have your loved ones been diagnosed with dementia?
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There are days when they will seem completely normal
and you will then doubt yourself.
With my husband he seems normal for a few days then bam he is gone again.
Some days he will say I know there is something wrong then other days he
will say there is nothing wrong with with him...
Very difficult situation...
You must take one day at a time.
Good luck
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Goodness, Marty, I just had a quick look at your profile. Do you have any support with looking after both of your new house guests??? Please feel welcome here, anyway - I hope you'll find lots of useful information.
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If you can explain what's the toilet fiasco was, maybe I could give a specific solution. If it's dementia, he's going to lose more of his abilities as time passes on. It's like as if they become like babies again, blissfully unaware of what they are doing. It would be a funny situation, if we had the energy to run behind them. Here are few tips: 1. Buy a glow in the dark tape, such as, flourescent tape (~$10 on Amazon) and stick it on the toilet door. You may also try taping around the toilet seat, so that he can find his way around and where to park his seat during night times. 2, You can offer your help to him, whenever he wants to use the restroom. 3, If you are sleeping separately, then you can set up a audio video baby monitor along with a wifi motion detector on the side of his bed to detect his movements and guide him in restroom activities. 5, Remove unnecessary clutter.  Keep basic things.  Keep the room well-illuminated.  6, Engage him daily in some brain activities.  7, Play soothing music, but keep the noise level down.  8.  Avoid confronting him on memory lapses.  You'll just succeed in stressing him or get confrontational.  9, Above all, be patient. Don't lose your cool. It's not worth it. 
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I would also note that the condition called Anosognosia, a deficit of self-awareness, a condition in which a person who suffers some disability seems unaware of the existence of their disability. It was first named by the neurologist Joseph Babinski in 1914. Anosognosia results from physiological damage to brain structures, typically to the parietal lobe or a diffuse lesion on the fronto-temporal-parietal area in the right hemisphere. While this distinguishes the condition from denial, which is a psychological defense mechanism, attempts have been made at a unified explanation. Anosognosia is sometimes accompanied by asomatognosia, a form of neglect in which patients deny ownership of their limbs.
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It takes a while to get the acceptance stage to any disease. However, it sounds like there may not have even been notification yet. I would suggest getting some professional help to work through those stages. Dementia is rough because the brain you need to make those mental changes is in the process of destroying itself.
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Yes, good answers all the above. While you didn't state exactly what the toilet paper fiasco was, I bet we can all hazard a guess! Blessings to you.
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My mother had times in the recent past where she'd blow things over as a joke saying "I'm losing it" or would get nasty and her come back would be "you'll be old one day too!" It's been obvious for some time she has dementia (at 95). Finally got her in for an assessment where she scored 7/30. While we were there she believed we were there for my father; and kept repeating how she was FINE and there was nothing wrong with her. And I see little sense it telling her because she will forget it seconds later.
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Welcome Marty30, you've come to the right place. It's difficult for me to go out to attend caregiver meetings, etc., and this site has helped me from becoming 'beyond burnout' .. my mom has Alzheimer's and is in denial if anyone mentions her memory... in many cases, she really doesn't have self-awareness... it's frustrating for everyone!
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Yes, both my parents were told that they have dementia by the specialist. they really didn't understand what it was. I explained it to them but within an hour or so they forgot about it. my dad passed away a few days ago but mom is still at home with me and shes out in space somewhere. I cant talk to her at all. I have no idea what she is rambling about anymore. its sad to see and deal with. I so miss my dad......
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