5. Motivation and Dementia

"Lack of motivation, or apathy, and lack of interest in activities affect over 70% of persons with dementia." [1]  So we need to find ways to motivate PwD for physical activity. According to K. Götestam and L. Melin [2], training activities increase when PwD are actively asked to participate, while reinforcement has no significant effect. Several studies exist on improving motivation in PwD. K.S. LeBar et al. [3] showed that emotion-based images might boost attention and activity in persons with early-stage Alzheimer’s. They concluded that extracting the emotional content of a scene is more important than details. They also noted that at least in early Alzheimer’s patients can sustain attention and orient themselves visually to emotion-based information. K. Mayers and M. Griffin [4] employed mechanical toys to promote movement. Using personally relevant activities and intimate photos [5], improved the motivation and attitude of Alzheimer’s patients. They showed the enhanced orientation in those with intermediate dementia and increased social competency in people with early dementia while stressing the importance of the relevance of the used mediums to the PwD.

R.S. Peters [6] describes that in order to motivate an organism, said organism needs some sort of drive and a goal that is preferable over other options. A drive is related to emotion, whereas a goal is an objective concept. Combining drive and goal results in a motive. A motive is needed when an action differs from routine behaviour. It describes a desired end situation, either subjective or objective. "The boy wants to do a good job" is an example of a valid motive. R.S. Peters [6] explains four different types of explanations. 'His reason' explanations are explanations based on the subjective reasons given by the individual who is engaging in the behaviour. For example, if someone says they are motivated to study because they want to understand a particular subject better, this is a 'his reason' explanation. 'The reason' explanations are based on objective reasons or causes that are clear to outsiders as well. For example, if someone is motivated to study because they want to get a good grade, this is a 'the reason' explanation. Causal explanations refer to explanations that focus on identifying the causes that bring about the behaviour or motivation. For example, if someone is motivated to study because they are afraid of failing a test, this is a causal explanation. Finally, end-state explanations state the ultimate goal or end-state that the individual is trying to achieve. For example, if someone is motivated to study because they want to become a doctor, this is an end-state explanation.

References

[1] Ann K. Williams. “Motivation and dementia”. In: Topics in Geriatric Rehabilitation 21.2
(2005), pp. 123–126. doi: 10.1097/00013614-200504000-00006.

[2] K. GUNNAR GÖTESTAM and LENNART MELIN. “The effect of prompting and reinforce-
ment of activity in elderly demented inpatients”. In: Scandinavian Journal of Psychology 31.1
(1990), pp. 2–8. doi: 10.1111/j.1467-9450.1990.tb00796.x.

[3] Kevin S LaBar et al. “Emotional curiosity: Modulation of visuospatial attention by arousal
is preserved in aging and early-stage alzheimer’s disease”. In: Neuropsychologia 38.13 (2000),
pp. 1734–1740. doi: 10.1016/s0028-3932(00)00077-4.

[4] Kathleen Mayers and Myra Griffin. “The play project use of stimulus objects with demented
patients”. In: Journal of Gerontological Nursing 16.1 (1990), pp. 32–37. doi: 10.3928/0098-
9134-19900101-08.

[5] M. HOFMANN, C. HOCK, and F. MÜLLER-SPAHN. “Computer-based cognitive training
in alzheimer’s disease patients”. In: Annals of the New York Academy of Sciences 777.1
(1996), pp. 249–254. doi: 10.1111/j.1749-6632.1996.tb34427.x.

[6] R. S. Peters. The concept of motivation. Routledge amp; K. Paul, Humanities P., 1969.