Repetition and Alzheimer’s

Alzheimers-pixabayPeople with Alzheimer’s or dementia often say things over and over.  They may repeat a word, question or activity. For instance, when a relative of mine advanced in his illness, he called family members with the same question six or seven times a day with the same question. It would have helped him and us better cope with his illness if we had better understood the underlying causes of his repetition.

But what causes this behavior? In most cases, the person’s memory and thinking ability has deteriorated because of the disease process. They are confused, disoriented, and looking for comfort, security, familiarity, and reassurance.

Causes

The main cause of behavioral symptoms in Alzheimer’s and other progressive dementias is the deterioration of brain cells. This causes a decline in the individual’s ability to make sense of their world. In these situations, most people don’t remember that they just asked a question or made a phone call.

People with dementia might ask repeated questions for other reasons. They may be expressing anxiety, asking for help or experiencing frustration or insecurity. For this reason, it’s important for caregivers to look beyond the question to the root cause. This task can be difficult, but our loved ones often provide clues with facial expressions and body language.

Because people with Alzheimer’s gradually lose the ability to communicate, it’s important to regularly monitor their comfort and anticipate their needs.

How to Respond

  • Look for a reason.
    Repetition may be a symptom of an underlying concern. Does your loved one repeat themselves more often at a certain time of day or in certain environmental surroundings? Could any external factor be triggering fear or anxiety?
  • Focus on their emotion, not their behavior.
    Take note of their tone of voice and facial expressions. Do you sense fear? Anxiety? Pain or discomfort?
  • Turn the action or behavior into an activity.
    Ask for help—sweeping the floor, dusting, folding towels, helping with a simple recipe, making a sandwich, and raking leaves.
  • Stay calm, and be patient.
    Reassure the person with a calm voice and gentle touch. Don’t argue or use logic, which will only frustrate your loved one.
  • Give an answer.
    Provide an answer each and every time you are asked. If the person with dementia is able to read and understand, consider writing down the answer and place it in a location where it is easy for them to see. But do not express frustration with your tone or body language, no matter how many times they ask. For them, every time is the first time, and they are asking with the innocence of a child.
  • Engage the person in an activity.
    Diversion can be helpful. Keep a list of simple chores, games, puzzles, and activities on hand, and try to redirect in a task that they enjoy doing.
  • Use memory aids.
    If the person asks the same questions over and over again, create reminders by using notes, clocks, calendars or photographs.
  • Accept the behavior, and work with it.
    Repetitive questions can be intensely annoying, but given the context of life, try to place the behavior in perspective. Repeating is part of the disease. It is not harmful. It is not personal. As much as you are able, be thankful for engagement with your loved one.

For more information and great resources on Alzheimer’s, visit the Alzheimer’s Association. You can also check out my books on caregiving:

Precious Lord, Take My Hand: Meditations for Caregivers

Ambushed by Grace: Help and Hope on the Caregiving Journey

It Is Well with My Soul: Meditations for Those Living with Illness, Pain, and the Challenges of Aging

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