Is it surprising that people are happier and better able to deal with their illness when they believe they are doing meaningful work and are useful to the people that surround them?
By "surprising," I mean that it does not contradict my model of how people behave. But by "obvious," I mean that, unprompted, I may not have considered it an important part of treatment.
My meta comment: don't dismiss something as "not surprising," and by proxy, not insightful or interesting if you had not already considered it.
This is one of the many reasons that thinking that "poor people" are just lazy. To feel useful is a very basic human need. To the extend that even very rich people that does not need to work still does it.
> The sisters who ran the home, though perceiving his confusion and delusion, respected and even reinforced the identity of this somewhat demented resident, who, they felt, might fall apart if it were taken away.
Maybe a definition of sanity is the ability to deal with the lack of purpose. Most people is going to feel stressed and try to find a way to be useful again. Only when you are sick - whenever is dementia or depression - you stop being able to find your place in the world by yourself.
Given how our minds work, self-reinforcement is a major factor. Negative commentary (and self-commentary) is hugely disempowering. I suspect that, in many cases, dementia is iatrogenic. In a way, it's like bullying someone in order to keep them irrational, defensive, and self-defeating.
And yes, "lack of purpose" is a huge issue. Or rather, lack of a future worth living into. That's also a huge part of dementia.
I found it fascinating to read that sentence when I read from the article that routine is critically important. The article didn't seem to say that usefulness or value were what mattered or necessarily considered rather that things were familiar.
More broadly I think that the belief you mention is primarily from the protestant work ethic [1 & 2]. Absent that social norm I'd argue that needing to feel useful and the associated need to work is not part of the fabric of humanity. Feeling needed and feeling that work is a reward is one path to happiness or pleasure but it is not the only one.
I think a case can be made of not wanting to be a burden on a loved one but, sadly & cruelly, at some point dementia robs you of even that worry.
[1]: https://psmag.com/economics/protestant-worth-ethic-real-6554... [2 linked from 1 & more succinct summary]: https://hbr.org/daily-stat/2013/08/there-really-is-such-a-th...