Is awareness of the condition of dementia only present in those whose dementia is mostly vascular? And is it a healthy condition? As a psychologist, I've always found awareness is the key to change and self-help. And my mother has never been in any way aware of her mental state, which was always marginally psychotic, and featured transient psychotic episodes of the most brutal kind to those closest to her. Now, she knows that she has lost her short-term memory completely. Her mind-state is terminally fearful, although she's such a drama queen that I tend to disregard any extremism she displays. BUT, what I want to know from others is - did your loved one show signs of awareness of the condition, and did it help? And was the condition AD or vascular? Her CPN, who is the doziest CPN in the history of psychiatric nursing, says that her 'awareness' may lead to depression, and if she were a different personality I might agree with him. As it is, I find that because she knows, albeit with her usual dramatic self-pitying and paranoid persona, there are times when I (whom she hates with a vengeance) can almost reach her, and help. I have recently given her a diary book, and have set up a notice by her front door that anyone who comes in must sign her book before they leave. This book enables her to access the date, day, and year, and see the people who have visited her, as she has the ingrained false belief that she has been abandoned by everyone. So when she calls, serially and repeatedly, and says that no one has been to see her all day, all week, I ask her to fetch her book, and read the last entry in it. It takes a while for her to be able to do this, but she can usually manage it. She reads it out painstakingly, by word, not by meaning, and this is a compassion issue for me, as she was a Primary school headmistress. My heart bleeds, as she says, 'But I don't remember this! Someone came today and I don't remember! I'm losing my mind!' The 'day book' has helped me to remind her of the present. She can see via the entries in it that she has maligned those whose kindness on a daily basis helps her through, although her lifelong self-pity clicks in and asserts itself when the reading of the book is in the past by five seconds. She's again the abandoned badly-done-to waif she imagines herself to be in the stories she tells about herself, to herself I really have no idea whether I'm helping or hindering by making these efforts to anchor her to the here and now. What do you think? Is awareness a good or a bad thing? And how have you dealt with it, when you've encountered it?