Hello RebekahJ! First time I've ever posted anything and you provided me with a unique perspective. My wife is at a moderate level of dementia having been diagnosed about 2.5 years ago. Unfortunately, in my mind, the disease is progressing very rapidly. She is struggling with expressing her thoughts to me but she is not nonverbal. Instead of having her become anxious because she becomes easily confused, I assist her with daily activities, but do most complex household tasks myself. She can perform her ADL's with some assistance. She is on four medications that have an effect on brain chemistry - one of which is an antidepressant. The apathy she has is exhibited by a lack of initiative, loss of interest and a lack of of emotion compared to her previous level of functioning. She does not exhibit depressive symptoms such as a sad mood or changes in sleep or appetite,etc. Apathy or depression? However, you make an excellent point that depression may exhibit itself differently in someone who is suffering from the brain damage caused by the disease. Her Dr. recommended placing her on another antidepressant to hopefully have a positive effect on mood which in turn may reduce the apathy so she will regain interest, intiative, etc. I'm hesitant to begin another drug and I'm trying to get her more involved in different activities. We walk every day for 35 minutes, participate in an "art cart" which she really enjoys , go grocery shopping, joining a volunteer group with our church and more. But, it's becoming exhausting for me because it's so difficult to get her motivated. She may need the additional antidepressant to have an effect on her apathy, but I'm trying to increase the variety of interventions hoping something will get her excited before I agree to begin another drug. If nothing works and her quality of life continues to decline, then I'll begin the new drug with the hope it has a positive effect.
Thank you so much for taking the time to share your thoughts with me. I value your input!

Hi Country Boy! I have a couple of thoughts about the apathy you are seeing in your wife. It is hard to know from your question how far along you two are in this journey, so I don’t mnow how much your wife can still communicate with you. She may not be able to verbalize how she is feeling either because she has difficulty expressing or explaining her emotions with words or because she can’t remember how. It is possible that she is experiencing some level of depression that is not showing itself in the way it would in someone who doesn’t have the brain damage that ALZ causes. My Mom’s neurologist put her on an antidepressant as soon as we got her diagnosis and I think it helped her in those first few years. It also may be that your wife is having trouble initiating activities that she does want to do because she can’t get from step 1 to step 2 or even figure out what step 1 is. For example. She may think “I would like to go take a walk.” But she cannot remember where the door is or she may think “I know I need shoes, but I don’t know where they are in this house.” She may feel like she doesn’t know what or how to say what she needs/wants. There is a time in this journey when we as caregivers start to “take over” the thinking and planning process for our loved one, placing needed items where needed and removing the mental and physical barriers to getting something done. Getting your loved one out and about may be really helpful, especially if the activities are designed to relieve decision making stress from her. Sending hugs and support!❤️