Understanding Apraxia in Dementia: What It Is and How You Can Help

Dementia affects the brain in many complex ways, and one of the most misunderstood symptoms is apraxia, or the loss of purposeful movement. At Home and Community Care Ltd. (HCCL), we believe that understanding the daily challenges people with dementia face is key to delivering better care and maintaining dignity at every stage.

Apraxia is one of the seven common cognitive changes associated with dementia, part of the “7 A’s” tool used to explain how this disease affects brain function:

• Anosognosia – Loss of insight

• Amnesia – Loss of memory

• Aphasia – Loss of language

• Agnosia – Loss of recognition

• Apraxia – Loss of purposeful movement

• Altered perception – Loss of perceptual acuity

• Apathy – Loss of initiative

  
  

🧠 What Is Apraxia?

A person with apraxia may know exactly what they want to do, understand instructions, and have no physical limitation in their muscles—but still be unable to perform a task. That’s because the brain can no longer coordinate learned, voluntary movements.

This can affect everything from using a spoon to buttoning a shirt—even when the person has done these tasks for years.

Apraxia is often seen alongside aphasia (language issues) and agnosia (recognition issues), adding complexity to daily caregiving.

🧩 Types of Apraxia You Might Notice

1. Ideomotor Apraxia

• Can’t perform a gesture on command (e.g. waving)

• Uses objects incorrectly (e.g. writing with a toothbrush)

• Can describe a task, but not do it

2. Ideational Apraxia

• Misorders steps in complex tasks like dressing or cooking

• May refuse a task—not from resistance, but confusion

• Forgets the use of common objects (e.g. how to use a fork)

3. Buccofacial (Orofacial) Apraxia

• Difficulty making facial movements like blowing a kiss

• Trouble eating or moving food in the mouth

• May resist feeding because they struggle to open their mouth

4. Verbal Apraxia

• Difficulty making the correct mouth movements to speak

• May swap words or say them unclearly (“chicken” instead of “kitchen”)

• Different from aphasia, which is about word understanding

5. Limb-Kinetic Apraxia

• Struggles with fine movements like using a remote or tying shoes

• Movements may appear slow or clumsy

• Loses finger dexterity for everyday tasks

6. Gait Apraxia

• Difficulty initiating walking

• Shuffling steps or poor balance

• May freeze mid-step or take short, unsafe strides

  
  

🤝 What This Means for Caregivers

As dementia progresses, apraxia can lead to increased dependence on caregivers. Helping with dressing, grooming, eating, and mobility becomes more time-consuming and emotionally complex.

It’s common to feel frustrated or overwhelmed, especially when you know your loved one wants to perform a task—but just can’t.

💡 Tip: If you’re unsure what type of apraxia your loved one has, keep a journal of observed challenges and consult a healthcare professional for assessment and guidance.

👕 Helping with Dressing: Practical Strategies

• Give short, step-by-step instructions

• Lay out clothes in the order they should be worn

• Choose adaptive clothing (Velcro instead of buttons)

• Avoid distractions during personal care

• Demonstrate the action—don’t just explain it

• Use calm, positive reinforcement

• If frustration builds, take a break and try again later

At HCCL, our trained caregivers are experienced in supporting personal care with patience, skill, and empathy.

🩺 How Professionals Can Help

A range of healthcare professionals can offer tools and strategies to make daily care easier and more empowering:

• Occupational Therapists – Recommend assistive devices and simplify daily routines

• Physiotherapists – Develop strength and balance exercises for gait apraxia

• Speech-Language Pathologists – Offer speech exercises or reading activities for verbal apraxia

• Therapy Assistants – Support restorative and re-enablement techniques

• Home Support Workers – Help with dressing, grooming, and mobility in a respectful, dignified manner

  
  

🧩 Montessori-Inspired Dementia Activities

These activities involve guided repetition, task breakdown, and failure-free tasks that help rebuild confidence. For example:

• Sorting colored objects

• Matching cards or textures

• Step-by-step cooking or craft tasks

HCCL incorporates such therapeutic activities into our personalized home care services, allowing clients to maintain a sense of independence and achievement.

💜 Support That Makes a Difference

Understanding the nature of apraxia is essential for both quality of life and quality of care. At HCCL, our mission is to help families create safer, more nurturing environments for loved ones living with dementia.

From professional caregiving to therapy support, we’re here to walk beside you every step of the way.