The Overlooked Side Of Mental Health Among Seniors With Dementia And Alzheimer’s

When we speak of dementia or Alzheimer’s disease, the conversation almost always revolves around cognitive loss, fading memory, disorientation, and decline in daily functioning. This narrow lens, while convenient, misses the deeper and far more devastating truth: dementia is not just a disease of the brain, but an assault on the human psyche. Beneath the failing neurons lies a mind that still feels grief, fear, loneliness, and despair, often in silence. Let us understand the mental health side of people dealing with dementia and Alzheimer’s.

Being Aware Is The Painful Phase

According to Neha Sinha, Dementia Specialist, CEO & Co-founder of Epoch Elder Care, “The most painful phase is not when memory disappears; it’s when awareness remains. In the early stages, many seniors realize they are losing control over their thoughts, speech, or recognition. That self-awareness, the ability to watch one’s own decline, is psychologically brutal. Studies suggest that nearly 40–50% of people living with dementia experience clinically significant depression, often triggered by this recognition of loss.”

This emotional trauma is rarely acknowledged. For a senior in the early stages, the diagnosis itself is traumatizing, often rendering them to mourn their own passing before time.
What follows is a slow erosion of confidence, a sense of worthlessness, and a terror of what’s coming next.

The Mistake: Misdiagnosing Emotional Pain

“Healthcare systems frequently mistake psychological agony for neurological decline. When a person with dementia withdraws, refuses food, or lashes out, it is often dismissed as “just Alzheimer’s.” Depression, anxiety, and even trauma can manifest as apathy, irritability, or confusion, but instead of compassion, these symptoms are often managed with sedatives or behavior-control strategies,” shares Neha Sinha.

Also Read: The Need for Assisted Living for Dementia Care for Senior Citizens in India

Apathy is not the absence of feeling, it is the exhaustion of trying to communicate in a world that no longer understands you. Anxiety in dementia can present as agitation or pacing, but these are often the only languages left to express fear. Ignoring this emotional distress compounds suffering and hastens decline.

The Terror beyond Mood

“The burden extends beyond mood to a range of agonizing experiences known as behavioral and psychological symptoms of dementia (BPSD), a study shows. In addition to apathy, psychosis causes terrifying hallucinations and paranoid delusions. Imagining intruders in one's living room or believing their own children are plotting harm, without the mental capacity to rationalize the fear. This experience is not mere confusion; it is an absolute, gut-wrenching terror that must be acknowledged as their daily reality,” highlights Neha Sinha.

Also Read: Reduce Your Risk of Dementia: Expert Shares CDC-Identified Factors to Watch Out For

Sleep Issues Triggering Mental Woes

Additionally, sleep issues rob them of their final bit of tranquility. When the brain's daily cycles are disrupted, confusion and anxiety arise, resulting in wandering, especially during the night. These emotional and behavioral difficulties are not only challenging to manage, but they also signal a faster cognitive decline and are the main cause of caregiver exhaustion and the necessity for institutional care.

Rethinking Dementia Care: From Disease to Human Experience

As per WHO, globally an estimated 55 million people live with dementia, yet nearly three-quarters remain undiagnosed or untreated. The world’s approach to dementia is still largely biomedical, focused on neurons, not narratives; on symptoms, not souls. This mindset must change.

We must recognize that dementia is as much a mental health crisis as it is a neurological one. It demands emotional containment, psychological support, and empathy-driven care as urgently as it demands medication or therapy.