Apathy and How to Help

What is Apathy?

• A symptom of dementia
• Loss of interest and ability

Although losing interest may not seem like a behavioural concern it is and can be very hard for care partners to cope with. Neuroscientists have found that apathy happens because of problems in the brain’s motivation pathways. If 100 people have Alzheimer’s, about 80% will develop apathy as a symptom. Sometimes apathy happens before memory problems. Apathy may often get confused with laziness or stubbornness.  Symptoms can also look similar to the affects of depression which can also be a symptom of dementia.

Apathy diagnosis in dementia will appear in these ways:

1. Goal-directed behaviours (e.g. starting and/or participating in conversations, doing activities of daily living, seeking social activities etc.)
2. Cognitive activities (e.g. loss of interest in news, personal, community or family affairs etc.)
3. Emotions (e.g. diminished or absent emotional responses to positive or negative events etc.)

Often due to damage to the frontal lobes of their brain. This part of the brain controls our motivation, planning and sequencing of tasks.

Things to looks for: emotional blunting, reduce display to positive or negative events, loss of empathy, being blunt in statements about others, indifference, social withdrawal, loss of self-initiation, need prompting, poor persistence, lack of interest in routine or new activities, difficulty planning and doing, reduced curiosity

Risks and concerns

• “Shadowing” (complete reliance on the care partner to the point that it becomes impossible to step away)
• Fear of doing new things
• “Use it or lose it” Since motivation and initiation are affected they are less likely to retain current skills.

How to help?

Tip: At times, they may respond better to non-family caregivers when it comes to initiating and participating in activities.

• Make One Change at a Time
• Small steps
• Use positive language
• Use incentives but not “if you don’t… you won’t”
• Create the right environment
• Be aware of good days and bad days
• Consider if they are just having difficulty with the task? And adjust
• Instead of asking do you want to? Time to…
• Be flexible on how things can be done
• Pick successful activities, avoid things that overwhelm
• Keep activities failure free
• Encourage a healthy routine