Apr 21, 2015

The Effect of Emotional Blunting and Apathy in Alzheimer's Care

What you are identifying is called emotional blunting, emotional flatness or apathy, not dislike from a person living with dementia.

Apathy in Alzheimer's care
By Carole Larkin
Alzheimer's Reading Room

A question from a daughter that lives far away and visits her mother a few times a year:
With all the transitions that have been going on with my mother, I haven't been calling so that she can she can get settled in and be less agitated.

That being said, I just off the phone with her, and she didn't sound happy to hear from me. She was starting to get this way with me before I left and was clinging more tightly to my brother, which I understand because he lives there.

How to Get Answers To Your Questions About Alzheimer's and Dementia

It's so difficult to not take it personally, because I've always been her confidant, her protector, and best friend. I know it's the disease, but it's so hard ... so hard. This was only the fourth time I've spoken to her since I've been back, and it's the same, each time, we speak.

What can you suggest for me to do when I talk to her? I'm going to be sending her a card this week. Maybe, that will make her smile for a few seconds.

Thanks for your time.

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Response from Carole:

What does she say is the reason she doesn’t “like” you anymore?

The daughter’s response:

She doesn't say why; she's just very indifferent with me, and if I tell her that I miss her or that I love her, her reply is that at least someone does. I'm getting the feeling that it wouldn't bother her if we didn't talk anymore, and that really hurts me, deeply.

Carole's answer to her:

Ah ha, what you are identifying is called emotional blunting, flatness or apathy, not dislike. 

That is common in the disease. It has little to do with her feelings for you personally. It has everything to do with the deterioration in her frontal lobes. Sometimes these changes in effect are lumped together in the term “personality changes”.

People can and do go from sweet to mean, and vice versa, as well as begin showing all kinds of different effects never exhibited before.

For example, men and women who were pastors and pastors’ wives begin swearing like sailors. You just never know what’s going to show up because it’s different with each person, and the effects themselves can change over the course of the disease.

Deep into the disease many people become almost still, as their focus turns from external stimuli (what they see, hear, feel, taste, etc) to solely internal stimuli (what is going on in their mind).

As for clinging more tightly to your brother, because he’s there, well yes, kind of. People with this disease live in “this moment” more and more. They can’t remember the past, and can no longer project the future, so the only thing that is important to them is “this moment”.

Yes, your brother is there and he interacts with her in the here and now, so of course she’s more dependent on him. Again, it has nothing to do with you personally; it’s just a function of location, location, location.

The more you learn about how Alzheimer’s affects people, and how you can better react to its challenges to your traditional relationship with your mother, and adjust your viewpoint of her and of your communication with her - know this. It has nothing to do with you, and really isn’t about you.

It’s so hard for us to get outside ourselves and try and view the world from the viewpoint of the person with the disease, but that’s exactly what you have to do to keep yourself from falling into the emotional traps of anger, guilt, shame and all the other negative emotions that arise in family members of people with Alzheimer’s.

I found a small paperback which is of enormous help in combating these negative emotions. I consulted it almost daily during the early stages of my journey of caregiver daughter of my mother with Alzheimer’s disease. I recommend it to all my clients’ spouses and children who are struggling with a loved one with the disease.

The title of the book is: “Coping with Alzheimer’s: A Caregiver’s Emotional Survival Guide.” It is written by rose Oliver and Frances Bock. It’s available on Amazon.com, (of course) and it’s cheap. It’s only $10 or so. I strongly suggest you get it.

It is beyond wonderful!

Carole Larkin MA, CMC, CAEd, DCP, QDCS, EICS is an expert in Alzheimer’s and related Dementia care. She is a Certified Geriatric Care Manager who specializes in helping families with Alzheimer’s and related dementia issues. Carole can consults with families via telephone nationwide on problems related to dementia. Her company, ThirdAge Services LLC, is located in Dallas, TX.

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Publisher: Alzheimer's Reading Room
Author: Carole Larkin
April, 2015
Title:The Effect of Emotional Blunting and Apathy in Alzheimer's Care

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