Behavioural changes in persons living with dementia can occur as a result of changes in their brain.

The Department of Psychological Medicine from Changi General Hospital (CGH), a member of the SingHealth group, explains the common symptoms displayed by persons with dementia and offers caregivers tips on how to better manage these behaviour changes when caring for their loved ones with dementia.

Apathy in persons with dementia

Apathy is a state of being indifferent to happenings in one’s surroundings and the well-being of family, friends or even oneself.

There is little emotional response throughout much of the day, and the person with dementia may spend the majority of their time in bed or being inactive.

Persons with dementia may exhibit apathetic behaviour at any time during their course of illness. This may increase the burden of family and caregivers as concern, love and care shown towards their loved one are not reciprocated.

5 Tips to manage apathy in persons with dementia

1. Arrange for a medical check-up when starting to notice signs of apathy

When the person with dementia starts to experience apathetic behaviour, arrange for a medical check-up to rule out the possibility of depression or other medical problems, and seek necessary treatment if required.

2. Avoid using force to get the person to act

Try not to force your loved one with dementia to do something against his/her will as it may upset the both of you. Instead, interest him/her in activities that he/she had previously enjoyed and are still capable of performing.

To invoke interest into activities, try injecting purpose into them. Also, ask your loved one for ‘help’ in completing basic tasks such as dusting, watering plants, washing rice, preparing ingredients, pairing up socks, folding clothes and sorting out beans. 

Better still, participate in the activities together with your loved one to keep him/her motivated.

3. Be selective when introducing activities 

If your loved one with dementia refuses to participate, try introducing activities that do not require participation to engage him/her. For example, listening to music, looking at old photos or reading to them.

4. Find out about the dementia day care centre near your home

Consider enrolling your loved one with dementia at a day care centre as he/she may be more willing to participate in group activities that allow interaction with peers. Check out this list from Dementia Singapore to find a dementia day care centre nearest you.

5. Don't forget to praise and reward!

Give frequent and appropriate praises or rewards to your loved one with dementia to instil a sense of well-being and raise self-esteem. The end result of the activity he/she participated in is not important. What is more important is that he/she was willing to participate and had fun in the process.

Reasons for apathy in persons with dementia

  • Progression of dementia resulting in changes in brain matter

  • The loss of ability to retain memory and perform complex tasks, such as making a snack when hungry or planning a day to occupy time

  • Depression

About BPSD (Behavioural and psychological symptoms of dementia)

Behavioural and psychological symptoms of dementia (BPSD) are neuropsychiatric symptoms and behaviours displayed by persons with dementia.

These symptoms constitute a huge aspect of dementia irrespective of its subtype, and they demonstrate a strong correlation with the degree of functional and cognitive impairment.

Learn how to manage anger and aggression, click here.

Learn how to manage disinhibited behaviours, click here.

Learn how to manage hallucinations, click here.

Learn how to manage paranoia and delusionclick here.

Learn how to manage repetitive behaviours, click here.

Learn how to manage sundown syndrome, click here.

Learn how to manage wandering behaviour, click here.

Ref: H24