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5 Ways to Respond to Repetitive Questions & Behaviors in Dementia

Loved ones with dementia often repeat  questions, words, sounds, or behaviors as a result of memory loss – their inability to retain and recall recent interactions, or things that they have done or said. This can be frustrating for caregivers who are often unsure of what is being communicated and how to respond.  Your loved one is completely unaware of their behavior which makes it even more challenging to address. It is important to know that repetition is often a result of increased anxiety, confusion, boredom, or a need for comfort and reassurance. 

Here we offer 5 tips to navigate this challenge.

 

1. Identify Potential Triggers

There may be a reason your loved one is asking the same question or repeating the same behavior. Are they thirsty, hungry, or in pain? Do they feel unsafe? For example, if your loved one keeps opening the fridge, perhaps they need to be reassured that there is enough food. If they look scared or anxious, let them know that they are in a safe place. Focus on the emotion rather than the actions/behaviors.

2. Responding to Repeated Questions

When your loved one repeats a question like “Where is my son?” or “What day is it?” it is reasonable to initially provide a brief factual response, but by the 20th time, your loved one likely needs an emotional, comforting response since they may feel anxious or confused. Remain calm and identify who you are, your relation to them, and let them know that they are safe, at home, and you are here to take care of them. Try to avoid saying “Don’t you remember?” as this could exacerbate negative emotions and increase agitation.  

Another tough question to answer is “Where’s dad?” when dad died years ago. It is very common for your loved one with dementia to ask repeatedly about a spouse, a child, or a friend who died years ago. Understandably, you don’t want to keep reminding them that their loved one is already dead since they will likely grieve and mourn anew. Instead consider saying “I’m not sure, I haven’t seen him lately”. In this example, if your loved one keeps asking about dad, consider exploring with them  “What did he like to do?”,  “What did he teach you?”,  “What did you love about your Dad?”. This allows you to connect with them as they recount their memories of this special person.

3. Redirect with an Activity

Many individuals living with dementia exhibit repetitive behaviors that are not harmful, such as rubbing their hands or fiddling with a sweater button or a zipper. In these cases, try providing them laundry that is easy to fold, or a cloth to dust off the table, or a fidget pen to keep their hands occupied. Perhaps they are bored and would benefit from fresh air or listening to music. A daily routine, with physical activity as tolerated, can help with the restlessness while also providing structure and certainty.

4. Create Memory Aids

For loved ones who are still able to recognize and engage with visual cues consider visual aids. For example, if your loved one keeps asking the day or month, provide them a visual reminder with a calendar and a clock with large letters and numbers so they can see it. Include photos of their early life and other keepsakes to reassure, familiarize, reorient.

5. Take a Break

Caring for someone with dementia requires patience and  proactively creating a support system of friends, families, hired help, and community resources. You can then lean into your support system and ask someone you trust to watch your loved one for a couple hours a week or enroll your loved one in a day program while you take a break. Caregivers also need to take time to care for themselves. You may find support through a caregiver support group or individualized caregiver coaching. If and when you do lose your patience, have compassion for yourself. You are doing the best you can do.

Bottom Line

Your loved one with dementia is asking the same questions or repeating the same behavior due to the underlying dementia. Empower yourself with these 5 tips to help you respond in a compassionate way that is more sustainable for you.  If or when you lose your patience, have compassion for yourself, and lean on your support system.

Become an Empowered Caregiver

If you feel overwhelmed by the day to day struggle and want to feel more empowered, work with us. We can walk you through caregiving challenges and help you enhance your support system. 

Ashwini Bapat, M.D. is a palliative care doctor, coach, and co-Founder of EpioneMD. She completed her Internal Medicine residency and Hospice & Palliative Medicine fellowship at Yale-New Haven Hospital and then worked at Massachusetts General Hospital and Harvard Medical School. She is inspired and awed by human resilience and the mysteries intrinsic to life and death.

Lisa Catalano, LICSW is a coach, an independently licensed clinical social worker, and a certified Hospice & Palliative Care specialist. She has over 16 years of experience helping adults of all ages facing serious or progressive illness navigate the complexity of medical decision making. She helps clients define their own journey and is a source of support throughout the process.

 

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