Responding to Repetition: Help for Caregivers of Alzheimer’s Patients

What Should I Do Now?

Lori Dierolf, BA, PCHA, CDP, CADDCT, CAEd ,

Alzheimer's

It happens every day. All day long. A person living with dementia asks the same questions...over...and over...and over again! For those who care for individuals living with Alzheimer's or another dementia-related disease - even the most patient of caregivers - it can become frustrating. So, what's going on?

The blame for all those repetitive questions lies within the person's hippocampus. This is where short-term memory lives, and it's also the first part of the brain impacted by Alzheimer's disease. Located in the very center of the brain (just above our ears and about an inch inside of our heads), the hippocampus is part of the limbic system.

The hippocampus is critical for remembering every day information. For example, when you tell a friend you will meet her at 3:00 pm today at Starbucks, that information gets sent directly to the hippocampus. However, because the plaques and tangles of Alzheimer's destroy the cells in this area, there's now a huge space where that information would be held. This means that, not only would your friend with dementia not remember the time and place of your meeting, she would also not remember that you even had a conversation about it!  

It can be helpful for caregivers to keep in mind that the memory issues of Alzheimer's are due to true physical changes of the brain. A person's memory will not improve if they just "try harder." Caregivers are human, though, and the repetitive questions can try the patience of even the best of us. So, what can be done?  

First, we must recognize that questions from a person living with a dementia-related disease are their way of communicating something to us. After all, if she didn't need something, why would she be asking you a question in the first place!? We need to determine what physical or emotional needs they are conveying to us with their question. Are they bored? Hungry? Needing a bathroom? Are they afraid? In pain? Anxious?  

Once identified, we need to address and resolve the issue so the person is no longer triggered by the thought or feeling that caused the questions. This may take time, and coaxing, and empathy on the part of the caregiver - but it is always worth the effort!  

What if doesn't work? Or what if it only works for a few minutes, then the person reverts back to their repetitive questions or behaviors? While every person is different, and while truly knowing a person's life history can be a huge help, there are some useful tips that can be employed when a person living with dementia is "stuck in a time loop."  

Often, moving a person to a different location and giving her something purposeful and engaging to do can stop the cycle (such as having a conversation about "the old days," folding warm towels, matching socks, sorting nuts and bolts, looking at pictures of babies or kittens, etc.). Because dementia-related diseases rob an individual of her ability to focus on more than one thing at a time, it is also helpful to put something into her hands. This allows her to focus on that item, instead of the thought or feeling that was causing the repetitive questions or behaviors.  

If you would like to learn more about the repetitive behaviors of Alzheimer's and other dementia-related diseases, consider attending the seminar Alzheimer's Disease & Dementia Care, developed by the National Council of Certified Dementia Practitioners and offered by Northampton Community College on October 2, 2018. All healthcare professionals and anyone caregiving for a family member who has Alzheimer's disease or dementia are invited to attend.  Successful completion of this session is the first step towards getting the Certified Dementia Practitioner designation with the NCCDP!  To learn more, please view and download the program flyer. To register, please click here.