Disorientation is a mismatch between where you are and where you think you are.
This could be your “location” in time, a physical place, a life experience, a situation…the point is that, in some way, “your reality” diverges from your actual setting.
Disorientation is a common symptom with dementia, especially in the later stages. It’s not always harmful (read When should I “correct” someone who’s disoriented? to learn more about that) but it can cause some problems.
Sometimes disorientation is the obvious source: Mom keeps asking where her grandfather is (despite his passing several decades ago); Dad calls your kids by your siblings’ names; your husband asks “when are we going to have lunch,” despite having just finished it. In all of those scenarios it’s clear that the people living with symptoms of dementia feel like they’re in a different place than they really are.
But there are other symptoms that may not be as obviously caused by disorientation. Of course, disorientation is only one of many possible causes for these, but it can result in:
- wandering or pacing
- repeated questions
- problems communicating
- obstinacy or rebellion
- weight gain or loss
- slips in personal hygiene
- “sundowning”
- agitation
- irritability
- sleep problems
Disorientation comes from the cognitive impairment (including memory loss) that defines dementia. Cognitive impairment makes it hard to make or act on connections or make sense of clues. This means that someone who doesn’t know where they are (memory loss) can’t use external hints to correctly place herself. She’s disoriented.
Clues are the things that, without even thinking about it, cognitively-normal people use to place themselves. “The sun is setting so it’s probably evening,” that sort of thing.
Connections are how you process this information. Connections result in reactions. “It’s raining outside, I should put on a raincoat and grab my umbrella on my way out,” is an example of a connection. Continue reading