Alzheimer's Apathy Preventable with Stimulation

Caregiver, patient expert

Lack of enjoyable, stimulating activity can lead to apathy for anyone but particularly those with Alzheimer’s disease. According to a 2013 report by the Centers for Disease Control (CDC), apathy is one of the most common neurobehavioral symptoms in dementia. Strong, focused stimulation can help people with Alzheimer's disease overcome apathy.

People with mild dementia will decline more quickly into severe dementia if they also suffer from apathy, therefore engaging, stimulating activities are especially vital to this group.

In an interview on Medical News Today, Ying-Ling Jao, assistant professor of nursing, Penn State University said, "Persons with dementia who are also apathetic won't be curious about the world around them; they are not motivated to carry out activities, nor engage with those around them, in either a positive or a negative way. Apathy has several negative consequences for both the persons with dementia and their caregivers. The individuals' cognitive function will likely decline faster and their caregivers will have more difficulty with their caregiving and are more likely to become depressed."

For the study, Jao observed by video 40 nursing home residents who had dementia as they went through a typical day. The purpose of this study was to examine the relationship between environmental characteristics and apathy in long-term care residents with dementia.

Jao looked at environmental stimulation, ambiance, crowding, staff familiarity and light and sounds. "Interestingly, our results showed that clear and strong environmental stimulation is related to lower apathy, while no stimulation or an overwhelming environment with no single clear stimulation is related to higher apathy," Jao said.

The researchers found that clear stimulation requires an environment without competing background noise and involved a single focus, as well. The example given is one already used by many good nursing homes which is having a music therapist lead a group in song or instrumental music. The key is not only music, though music can be a tremendous help in both stimulating and calming people with dementia. The key that makes this therapy most effective is the singular focus without competing stimulus.

Jao said that the strength of the stimulus depends on how intense, persistent, interesting and out of the ordinary it is. Routine activities, such as a regular conversation or meals, are considered moderate stimulation while a celebration or party is considered strong simulation.

Art therapy shown to reveal creative gifts

Increasingly, studies are showing that the arts, whether music, theater or hands-on fine arts stimulate creative energies for people with Alzheimer’s and other types of dementia. Many find that once liberated from the inhibitions of the mind that were there prior to the disease, the ability to create is somehow freed.

Non-drug, hands-on, personal care incorporating stimulating activity has been shown in the past and, I believe, will continue to show the best results in Alzheimer's and dementia care. Our care facilities need to be funded in such a way that activity specialists can be part of the staffing. These specialists will be able to provide the strong, focused stimulation required to prevent apathy in our loved ones who have Alzheimer's or another dementia.

Carol is a newspaper columnist and the author of Minding Our Elders: Caregivers Share Their Personal Stories. She runs award winning websites at _ www.mindingourelders.comand On Twitter, f_ollow Carol @mindingourelder and on Facebook: Minding Our Elders

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