Apathy or depression

nancym157

I am new to the forum and would like some help in understanding dementia related symptoms. I moved my 90 year old mother from an independent living facility in PA to an assisted living facility in Maine (where I live) in January 2020 when her dementia seemed to worsen suddenly. I did not realize the extent of her dementia at the time of her move and the AL facility I chose was not a good fit for her. My husband and I brought her into our home in March 2020 mostly due to Covid and the fear of her being isolated in a new environment. An appointment last March for a dementia evaluation was cancelled d/t Covid. 

Immediately prior to the move and since then she has exhibited no interest in any activities. I have tried to engage her in looking at old photos, crossword puzzles (which she used to love), watching TV, cooking/baking and knitting. She seems to prefer sitting in her recliner usually with her eyes closed with very little interaction or engagement. I would like any help in understanding this behavior and any suggestions. She was started on an antidepressant January 2020 but this has made little difference. I have read that people with dementia can exhibit apathy. She says she is not depressed and when she does engage she does not seem sad. I only want the best quality of life for her and it saddens me to see her sit for hours.

Thanks in advance for any thoughts or experiences you can share.

Rescue mom

It’s very common for people with dementia to no longer be interested—or usually, no longer able to do—things like cooking or crosswords or knitting. Their brains just don’t work that way anymore. Many don’t remember people in photos, so no interest in those.  Nor can they follow TV plots/stories, although many seem to be OK with very simple things like animal shows or old comedies, or variety shows. 

They may well have liked and done various activities before, but dementia takes away those abilities and interests. Yes, apathy is often part of dementia, but also, they simply just cannot do the things they used to. That’s dementia. Their brains are broken, not working like they used to. They may enjoy, or do, things that seem very boring to us, like watching out a window, but we don’t have dementia.

Cynbar

This sounds very much like my DH. He used to be an active and engaging person, but now he is content to just sit quietly on the couch, eyes open or closed but not sleeping. I've given up pushing him to do things, it just gets him upset, but I do often turn on a ballgame or news or some music for him. He doesn't seem to pay a whole lot of attention, but it makes me feel better! I don't think he's depressed, he's sort of living in his own alternate universe ---- it seems to be apathy to me. I often remind myself that the focus needs to be on him, and not on my projection of what he should be doing. Some days this is easier than others.........

Bluecard 18

https://alzconnected.org/discussion/comment/85081#Comment_85081

This is something I tend to worry about as well—the lack of engagement in anything unless initiated by others (no longer reading, initiating listening to music/watching things, etc.) so often try to stop by my LO's AL place and turn something on as I'm leaving as I think he does pay some attention once a game or a show is on. I know if with someone, he's more inclined to pay attention. However, he doesn't ever seem to turn it on himself. I think the staff does sometimes, and I have put a list of some favorites on a bulletin board in case he or the staff check it and think of turning it on. Any other suggestions welcome, though I am trying hard to take the above to heart: to remind myself that the focus is on him and not my projection of what he should be doing. And yes, some days easier than others. Thanks for the insights.

M1

Bluecard, welcome to the forum. You have posted on a very old thread, you may get more responses if you start a new discussion.

Apathy and loss of executive function are part and parcel of dementia. Have you considered that he might do better in memory care, as opposed to assisted living? Staff in MC are likely to have more training specific to such dementia behaviors.

Bluecard 18

Thanks so much—I'll plan to start a new thread on the apathy topic. And I appreciate your question and will plan to explore and give thought to that as I observe overall and see how he continues to adjust (he recently moved to this AL from out of state to be close, where he was in IL but with added assistance, and when I began to realize he needed more help). Overall he seems to be doing great, I must say, though without initiative/exec function. I do know that it was the same for some time where he had been; I just see it more first-hand now, I guess. It is a tough/scary question to consider—I think mostly because the MC section is "secured" (I believe all are). I didn't mention that he eats all of his meals with others in the dining room (yes, he's directed when to go) and has several small groups he eats and converses with, I know. He also does go to the exercise classes and some activities—I think all with prompting.

As of now, the recommendations had been for AL, but I know he may be "in-between"—I will see how things go and try to get input from the staff, therapists, etc., as things go forward. Thanks again, and thoughts welcome.