Many forms of dementia remove self-motivation, the loss of executive function. People lose the ablily to initiate activity. They can’t get out of their own way. They are lost until someone tells them what to do or where to go.
Gone is the ability to plan a meal, cook a meal, or to follow a recipe. Long ago Mom lost the ability to make the connection from "I'm hungry" to “I can go to the kitchen and find food”. Now she can not even make the connection from “I’m hungry” to “I can ask for food”.
So the feeling of “what should I be doing” has no answer. There is just a lost feeling. There is no response coming from the brain that says: read a book, clean the house, feed the birds, go for a walk, sing, fold laundry, play the piano, work on a puzzle, write a letter, pay the bills, watch a movie, knit, whittle, call a friend, bake cookies, or make a sandwich.
Her motivation is broken.
This is why when you visit people with dementia, you sometimes see them sitting, just sitting. They are lost, there is no motivation, they don't know what to do, or how to go about doing it. They need someone else to direct their actions. We need good activity leaders. Come for a ride. Let's get an ice tea. Let's sing together. Let's go to worship. Help me fill the bird feeders. Let's work on this project. Tell me about your trip to Europe. Let's play Bingo. Come fold laundry. Let's look at your photos. Help me water these plants. Let's go for a walk. Let's go down to dinner.
We need good activity leaders. It makes all the difference.