I’m Not Lazy

Adynamia:

• After brain injury a person may show decreased or lost motivation and drive and have difficulty planning or carrying out activities. They may experience loss of interest and enjoyment of previously enjoyed activities and interests.
• It can cause greater difficulty with new or more complex activities and behaviors, particularly those with many steps, or where there is a sequence of tasks.
• Sometimes a person will be able to talk about plans, goals, and activities that they want or need to do but have difficulty starting or completing them. The person may know what to do but may not do it.
• Most people with adynamia will still be able to carry out many of the normal everyday activities, particularly if those tasks are easy, familiar, well-structured, or are routine or habitual activities.
• In severe cases of adynamia, a person may be unable to perform basic self-care activities such as showering, dressing, may not eat, or may not take care of basic household tasks e.g., cleaning, taking medication, taking out the rubbish, paying bills, contacting friends or family.
• People may think that the person with adynamia is lazy, lacking in motivation, or think they are not making effort, but the brain injury itself will often be the cause of the problem.

Resource: Understanding Adynamia and Lack of Motivation. ©The State of Queensland (Queensland Health)2021. Reviewed Feb. 2021. For Review 2022. ABIOS Neuropsychologist

Veronica wants to volunteer. Veronica wants to work. She feels like her life is empty and has no purpose. I feel horrible about this. She wants to do things without me but can’t get started without me.

When trying to work, she will do what she is told, then stand and wait to be told the next step. How can one work or go to school or complete anything but simple tasks without the ability to get started, being motivated? And with poor short-term memory, how can she be able to carry out tasks through to the end. Veronica is frustrated and saddened. I don’t know how I can help except to be here for her, listen to her, and help her get started after her tantrum is done. In hindsight she does realize this is a problem for her, but accepting it is something completely different.

Veronica is having a hard time these days. Today she had an appointment with a foot doctor, and she is supposed to soak her feet daily in a medicine prescribed by the doctor to get rid of painful cracks. We have gone to three other foot appointments and the past two, he has said, “If you soak your feet the problem will go away.” Veronica says it is too much work.

All she needs to do is get the foot tub and fill it with water. And put the medicine that is kept in the fridge in it. She has time every day to do this. She can soak her feet for 20 minutes while watching tv. I found out today the problem is not sitting and letting her feet soak. The problem is getting the motivation to initiate and start the actual process of getting the water bucket filled. This problem is called adynamia.

Just today it hit me, Veronica is not capable of getting started. I will be getting her water bucket for her because she needs that in order to complete the task of soaking her feet.