“I used to enjoy painting, but I often lack motivation. If I start, I usually keep going and am happy doing it. It takes a lot to get me started though.” (George)

Lack of motivation and apathy are frequent problems in dementia care. Very often, a reduction in motivation & a sense of purpose comes with cognitive decline: The progress of the disease sees the person losing interest in things they used to enjoy, such as hobbies or activities. They may spend time sitting and not interacting with anything around them, either disinterested or unaware of their surroundings, or have violent mood swings where they lash out with anger for no apparent reason.

One possible reason for this is that the underlying motivational drives may still exist, but the person may have deteriorated beyond being able to fulfill the needs that arise from these drives. They may also feel the drive and not remember how to meet its demands, or not remember what they wanted long enough to complete the task.

Despite losing a large amount of their memory, and many abilities and skills, it is important to remember that the emotional side of the person that experiences and feels things may still be present. Either one of these – the presence of feelings that aren’t able to be communicated or drives that aren’t able to be met – could be an explanation for activities such as wandering, crying and screaming, and other behavior that may be displayed by people with dementia.

It becomes increasingly difficult for the family and caregiving staff to deal with apathy and some of the associated behaviors, particularly if the person with dementia has always been a fairly active person.

Here is a list of potential helpful advice on how to drive motivation and sense of purpose through engagement:

• Focus on what the person is interested in & that remains challenging without being overwhelming.
• Encourage the person to remain active but don’t insist.
• Compliment the person from time to time on what they have achieved.
• Start something yourself and invite the person with dementia to join in.
• Provide guidance and cues during the activity if needed.
• Avoid offering activities when the person with dementia is stressed, tired or in a potentially frustrating situation (e.g. in front of strangers).
• Try to arrange something interesting each day.
• In the morning, people have more energy and might be more prone to engagement.
• Look for things that you could enjoy doing together
• Try to maintain a stimulating environment but make sure that it is not too much for the person with dementia.