Apraxia

Apraxia is a neurological condition that affects the ability to plan and carry out purposeful movements, despite having the physical strength and coordination to do so. In dementia, this means a person may struggle with tasks they have done thousands of times before — like brushing their teeth, buttoning a shirt, or using cutlery — not because of weakness or stiffness, but because the brain can no longer sequence the necessary steps.

There are different types of apraxia. Ideomotor apraxia affects the ability to carry out a motor command — for example, if asked to wave goodbye, a person may not be able to do so on command, but may wave naturally when someone is leaving. Ideational apraxia affects the ability to sequence multi-step tasks — a person might put their shoes on before their socks, or try to eat soup with a fork.

Apraxia is common in moderate to advanced stages of Alzheimer's disease and can also occur in other forms of dementia. It can be particularly challenging for daily care, as tasks like dressing, eating, and personal hygiene become increasingly difficult for the person to manage independently.

As a caregiver, you can help by breaking tasks into smaller, simpler steps and guiding your loved one through each one. Laying clothes out in the order they should be put on, providing gentle verbal cues, and demonstrating actions (so they can imitate you) can all be effective strategies. Avoid taking over completely — helping your loved one do as much as they can maintains their sense of independence and dignity.

An occupational therapist can assess the specific types of apraxia your loved one is experiencing and suggest practical adaptations for your home environment and daily routine.