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Dementia is a condition that has far reaching consequences. For both the people managing its effect on their brain and lifestyle and for family members that are alongside them. To enter into this discussion is to first acknowledge how difficult it is. How difficult it is to have your life change so much when coping with this condition and to see a loved one go through such frustration and change. This topic is an extremely personal and sensitive one for so many and should be, and shall be, treated with care and compassion.
According to the Psychiatric Times, “Apathy is characterised by a loss of motivation, diminished initiation, poor persistence, lack of interest, indifference, low social engagement, blunted emotional response and lack of insight.” These factors can be really scary for family members who started seeing their loved one withdraw but there are things you can do about it. There are ways that you can bring them back and forge a connection.
For those caring for loved ones with dementia, you may have noticed that they have a tendency to look straight through you. Have they been unwilling to engage in conversation? Have you sensed that they have been withdrawing from connecting with you and the family? Hesitating from activities that they formerly adored? What may be occurring is the symptom of apathy. Linked with dementia, studies have shown that apathy may be one of the symptoms by which dementia is expressed.
Your loved one may be withdrawing for many reasons. Dementia affects areas of the brain that are in charge of planning, initiating and carrying out a task. The ‘match’ that was usually there to fire up an activity may be damaged and so deciding, enjoying and finishing an activity can be very difficult.
Having the way you have thought and used your brain change with dementia can be an extremely complex journey of emotions. From confusion to fear, anger, embarrassment and grief, your loved one may be withdrawing to manage all these feelings. Depression may be another element that they are dealing with.
Tiffany Chow, an assistant professor of neurology and geriatric psychiatry at the University of Toronto stated that, “”In the beginning stages of dementia, people may withdraw from activities because they’re aware of what’s going on and want to avoid making themselves look bad, then in the moderate severe stages, they do shut down and are not able to initiate their own activities.”
The medical community believes that apathy has a significant effect on people with dementia and their families. They believe the condition leads to decreased function, those with apathy were 3 times more likely to struggle with dressing, bathing, moving from bed to chair, using the toilet, eating and walking. Philippe Robert a doctor and director of the Memory Center for Care and Research at Nice University hospital in France stated that, “Without interest or initiative, it’s difficult for these patients to use their remaining cognitive function.”
While many of us will leap at the opportunity to do most household chores or make decisions for our loved ones with dementia, this can sometimes lead them to be bored and worthless. A tip is to gently allow them opportunities to engage and be a part of the functioning of your household or residence. Pick activities that match their level of ability and build up from there.
Medication and illness may be another reason behind their apathy. With many medications affecting energy levels and concentration ability, focus and the desire to engage may be dampened. Be sure to regularly check with your loved one’s care team if they are taking medication, particularly any antipsychotics.
This is a new area of focus for the medical community. It is likely that more information on apathy within dementia will be forthcoming. Seek counsel from your trusted medical professionals in your journey to ask more questions. Dementia is a difficult, confusing and sometimes really dispiriting condition to be managing in a loved one. Using your support network to engage with new information like this is a strategy to coping.