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One Pager Apathy

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Apathy is one of the most common challenges amongst people living with cognitive change. Possible causes of apathy can include: ● Brain change (often in the frontal lobe, which affects initiation, motivation and planning) ● Learned Helplessness: when challenge is significantly eliminated from an individual’s life, he or she will automatically begin to defer to a care-partner in lieu of making choices. This may unintentionally reinforce the mindset. Symptoms include: ● Diminished initiation ● Poor persistence ● Lack of interest or indifference ● Loss of social engagement ● Blunted emotional response ● Lack of insight Apathy is often overlooked as a behavior and has negative consequences including: ● Contractures ● Deconditioning (often to the point of needing support from two or more people) ● Fear around movement ● Fear around touch ● Increased struggle with care processes (for instance, general movement necessary for walking, bathing, dressing, and other activities of daily life) ● Keeping individuals living with dementia from being motivated to participate in their daily care and routine This can bring about a faster cognitive and physical decline for the individual, as well as a diminished sense of meaning and purpose The treatment of apathy involves a three-pronged approach: changes in care-partner actions, environment, and (possibly) medications. ● When creating solutions, it is important to make one change at a time and give the individual sufficient time to learn and respond to the change. ● Start small: for instance, start with listening to music together rather than expecting a dance immediately. ● Use positive language: instead of “no, don’t” or “let me do that,” try saying “yes!” ● Often, well-meaning loved ones take over processes or decisions in the name of safety. However, this can inadvertently compromise an individual’s sense of self-efficacy and self-determination, resulting in further withdrawal. ● Individuals benefit from having one point of focus that matches the person’s skill and interest. For instance, long movies or programs with plots that are difficult to follow may be less engaging than musicals, short clips, and other visually engaging images that can be responded to “in the moment.” A person living with learned helplessness did not develop his or her change in behavior overnight. It is going to take time to “unlearn” the learned helplessness! It’s important to present small adjustments and honor decisions consistently with patience for your loved one and self!

©2021, Inspired Memory Care, Inc.


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