This will be the last of my posts about Apraxia. As I stated at the beginning of this Substack series, my purpose is to provide information about what is going on with the dementia patient, what is normal and what isn’t, and what am I, as a caregiver, supposed to do. I feel that I have gone as far as I can go with Apraxia because any further research will take me into technical medical resources that I don’t understand.
Here is a summary of what seems to be the most prevalent types of Apraxia and of each one’s characteristics.
Ideational Apraxia - This type is really debilitating and, I would think, perplexing to the person trying to perform daily activities. It is a situation where the person can’t figure out how to do a task requiring multiple steps. This is an early warning sign of cognitive decline that would come after the memory issues. It is particularly common in Alzheimer’s disease.
Examples: preparing a simple meal, trouble using a smart-phone, using a coffee maker, or packing a suitcase.
Notice how each of these examples require multiple steps that should be second nature to adults who have done each one correctly many times.
Ideomotor Apraxia - I think this is the one that would cause the most frustration. I know it would for me. This type has the person knowing and understanding the actions required to do a task and having the physical ability to do the task but is unable to do the task. In the video in the first blog in this series, the narrator commented that the simple act of pouring a cup of coffee can have messy results.
Examples: inability to demonstrate brushing teeth, difficulty waving goodbye, demonstrating how to use a key or a hammer.
Limb-Kinetic Apraxia - This involves the loss of the dexterity of the fine-motor movements of the hands and fingers. This will certainly affect a person’s ability to perform daily activities independently.
Examples: difficulty writing or typing, manipulating small objects like coins, buttoning a shirt, using utensils.
Dementia is an evil malady. Destroying a person’s mind is destroying that person’s individuality; it is taking away what is real and true about the person. Apraxia seems to take away a great amount of everyday skills while leaving the individual with the awareness that he or she should be able to accomplish a task.
Please understand that the dementia patient’s goal is not to frustrate you as a caregiver; be patient. I know it is hard because your other responsibilities are still going on, and you have the added problems of monitoring someone who was once capable and independent. When apraxia is added into the mix it can seem that it is the last straw.
Being a caregiver for a dementia patient may be the hardest thing you will ever be called to do. You can do it, but not alone. Ask for help. Find small moments to sit quietly and just breathe. Be prepared for the unexpected.