The Apathy Syndrome
Apathy refers to lack of interest, pleasure, or emotion. Apathy is frequently referred to as “lack of motivation.” Motivation is concerned with understanding the “direction, intensity, and endurance” of goal-directed behavior. Nearly 40 to 50% of patients with dementia develop apathy in the early and intermediate stages of their disease. In most cases it is seen in the Mild stage but can start during the Early stages of illness.
Day to day symptoms of someone with apathy syndrome include:
Decrease in your loved one’s usual activity or work patterns.
Subtle inefficiencies in the way they get their work done at home or at work
Impairment in starting and staying with goal-directed behavior such that prompting is needed to perform activities of daily living
Decrease in goal-related thought content, such as making plans, being curious, or having interests.
“I have no plans”, “I’m just not interested in much anymore” or “I have little desire to do anything today”
Reduced emotional responses to goal-related events.
A person with apathy, faced with personal loss or health problems, are described as emotionally indifferent
Favorable events are met with reduced emotion as well
Motivation is important for human adaptation. Therefore, patients with apathy suffer from an impairment which causes disability in virtually all essential areas of human functioning. Decreased motivation increases the risk of treatment failure because patients are likely to not initiate or continue to follow prescribed treatments.
Loss of motivation can also affect decision-making and behavior. Because of this loss of motivation, the burden of decision-making falls to caregivers. If a person lives alone, apathy can lead to skipping medications or meals, which can then lead to weight loss.
Apathy vs. Depression
Apathy would likely appear as if your loved one is quietly content. Depression could appear as though your loved one is sad, angry or irritable.
If you have any questions about whether your loved one is having apathy or depression, contact your personal physician, who will complete an evaluation and help clarify the diagnosis and any treatment.
Strategies for Coping with Symptoms of Apathy
It is common for family members to struggle with how far to “push” their loved one in an effort to get him or her motivated, which can result in conflict or guilt.
Often, caregivers seek to encourage and motivate. Sometimes, starting a task or cuing may be helpful in getting your loved one engaged. Other times such efforts result in resistance and/or frustration. When frustrations arise, in either the caregiver or the one being cared for, it is generally best to “let it go” or at least take a break and consider other options. In other words, “choose your battles.”
Try to encourage your loved one to do whatever they are able to do for themselves and only offer as much help as is necessary. If they are struggling with a task, avoid the temptation to take over completely, even though it may seem easier and quicker. If you need to offer assistance, try to do things with the person rather than for them. The person will then be more likely to feel involved.
It is more important that the person feels useful than that they complete the task perfectly. Praise, encouragement and humor are much more effective than criticism.
Consider arranging for your loved one to attend an adult day center. Accept offers of help from friends or arrange for a companion service. This may stimulate your loved one and engage them in new activities.
