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  • Writer's pictureBarbara Huelat

How Does Dementia Impacts Decision-Making and Judgement?

Watching my husband casually slip restaurant utensils into his pocket or my late mom frantically rushing into a neighbor's house convinced of an imminent threat, it became painfully clear: dementia doesn't just steal memories; it reshapes how we perceive and respond to the world. Even my grandmother's fascination with other people's clothes, leading her to hide in my closet, underscored the bewildering grip this condition has on one's mind.

Dementia, including Alzheimer's disease and other related conditions, impacts decision making and judgement by targeting the cognitive functions of the brain. Beyond mere memory loss, these conditions disrupt the brain's ability to filter information appropriately and make sound judgements. As a result, individuals with dementia may struggle to navigate everyday decisions, often living solely in the present moment without considering future consequences or broader implications. Those affected no longer seem able to ponder the future or weigh the consequences of their actions. It's as if they're trapped in the immediacy of the present, with no tether to past experiences or future implications.

Consider my husband's impulsive act with the utensils: a seemingly harmless action, but one that reflects a disconnect from the norms of social appropriateness. Or my mom's paranoid episodes, which could escalate into full-blown hysteria at the slightest trigger, leaving her—and us—terrified and exhausted. And then there were the countless times my grandmother would retreat into her own world, finding solace in the simplicity of other people's belongings.

These behaviors, while perplexing, are rooted in the complex interplay of cognitive decline:

Reasoning Impairment: Complex situations become inscrutable puzzles, and logical decision-making becomes a distant memory.

Memory Loss: It's not just forgetting where the keys are; it's forgetting why they matter and how they fit into the larger picture of daily life.

Consequence Blindness: Actions lose their context, and the ability to foresee outcomes dims, leaving decisions untethered from their repercussions.

Judgmental Fog: What once seemed obvious now eludes grasp, leaving individuals adrift in a sea of uncertainty, unable to discern right from wrong.

Impulsive Reactions: Urgency replaces deliberation, leading to rash decisions made in the heat of the moment, consequences be damned.

Prey to Predators: Vulnerability skyrockets as the fog of dementia clouds judgement, leaving loved ones open to exploitation, scams, and manipulation.

Navigating this terrain requires patience, empathy, and a willingness to adapt:

     Simplify Choices: Break down decisions into manageable chunks, offering clarity amidst confusion.

      Provide Compassionate Guidance: Be the steady hand navigating turbulent waters, offering support and reassurance every step of the way.

      Preserve Dignity: Foster autonomy whenever possible, allowing individuals to retain a sense of self amidst the chaos of cognitive decline.

      Lean on Loved Ones: Family isn't just a safety net; they're partners in this journey, offering insight, support, and shared burden.

On the front lines of caregiving, vigilance is paramount:

      Protect Finances: Shield loved ones from financial harm by implementing safeguards and closely monitoring accounts.

      Monitor Communications: Stay alert for signs of exploitation, whether it's a suspicious phone call or a too-good-to-be-true offer.

      Educate Yourself: Knowledge is power, and understanding the tactics of scammers is the first line of defense against their deceit.

Dementia impacts decision-making
Dementia Impacts Judgement

In conclusion, dementia presents profound challenges that test our compassion and resilience. Yet, through understanding and support, we can empower our loved ones to navigate the complexities of decision-making and judgement with dignity and grace. How will you contribute to this journey of care and advocacy? For practical strategies and deeper insights, consider delving into my latest book, "Taming the Chaos of Dementia: A Caregiver’s Guide to Interventions That Make a Difference." Together, let's make a meaningful difference in the lives of those affected by this relentless condition.


Barbara Huelat, a dynamic force in healthcare design, author, and speaker, generously imparts her expertise in her latest publication, ‘Taming the Chaos of Dementia.’ Drawing from her profound understanding and passion for the subject, she delivers practical wisdom on navigating dementia care with empathy and skill, transforming this complex challenge into a empowering journey. Dive into Barbara’s world at for an enriching experience.

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