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Understanding Challenging Dementia Behaviors: Repetition (Part 2 of 4)

Alzheimer’s disease and other dementias affect the brain in different ways. Memory loss is one of the most well-known hallmarks of the disease, but if you speak to caregivers and professionals, you’ll soon hear about “challenging behaviors.” In this four-part series, we’ll explore some of the more challenging behaviors you may have to address as a caregiver to someone with dementia.

“What day is it?”
“Where are we going?”
“Where’s David?”

All these questions are innocuous and fairly easy to answer once or twice. But for someone with a dementia such as Alzheimer’s disease, asking once or twice can turn into asking twenty or thirty times, which can be incredibly frustrating and annoying to caregivers. Whether a loved one is asking, saying or doing something over and over, the repetitive nature of their actions can feel a bit like undergoing water torture.

“Because cognitive diseases like dementia cause a person’s short-term memory to deteriorate, your loved one probably doesn’t remember that they’ve just asked you that question a dozen times already,” says Andrea Campisi, Marketing and Admissions Director of The Reutlinger Community, a Continuing Care Retirement Community in Danville, CA. “They’re not doing it to be annoying – they truly have no memory of doing or saying whatever it is that’s annoying you. That’s why caregivers need to understand the reasoning behind the repetitive action and equip themselves with caring techniques that can reassure and redirect your loved one before you become too frustrated.”

Why is my loved one doing that?
Repetitive behavior can take the form of questions, repeating a word or phrase or doing (or undoing) a task over and over. While sometimes the repetitive behavior can be attributed to short-term memory loss and not remembering that they’ve done/said/asked that particular thing already, that’s not the only cause. Here are some other possible reasons why a loved one is engaging in repetitive behavior:

  • They’re anxious, confused, afraid, angry or in pain
  • It could be a side effect of a medication they’re taking
  • They’re trying to express their needs (like hunger or needing to use the bathroom), but can’t put their thoughts into a logical order
  • They’re separated from someone they love and don’t know or can’t remember why (for example, a wife who keeps asking about her deceased husband)
  • The environment is causing them stress
  • They’re under stimulated or bored

While it’s tempting to attribute the behavior as a need for information, Andrea says that it’s more likely that your loved one has a need for reassurance. “Seniors with dementia aren’t repeating themselves or questions because they want to know the information,” she says. “They’re asking because they’re frightened, stressed, or anxious, and they’re trying to make sense with what’s going on around them.”

Tips for dealing with repetitive behaviors.

Repetition of any sort is frustrating and exhausting for caregivers, especially if you yourself are in a heightened level of stress. Before you get to your breaking point, take a deep breath and use some of these techniques to diffuse the situation, comfort your loved one and move past the challenging behavior.

Ask yourself: Is this behavior harmful or just annoying?
As with lots of things when it comes to dealing with dementia, you may just need to pick your battles. Is your loved one doing something that could potentially harm them, like taking things off high shelves over and over? Or are they simply causing frustration by asking the same question over and over? If it’s something innocuous, it may be best for you to just let it go. However, ignoring the behavior does not mean ignoring your loved one. Remember, this is frustrating for your loved one, too, and if they feel like they’re being ignored, they can become even more anxious, insecure and agitated. Redirecting their attention may be the best strategy.

Pay attention to your loved one and reassure them that you care.
Even if he or she is asking the same question for the twentieth time, take a moment and really listen to them. Make eye contact, be reassuring and show them that you truly do care about their feelings and needs. Don’t remind them that they’ve asked the same question over and over. Use a caring touch to show your feelings towards them and reassure them.

Listen to the reason behind the words and react accordingly.
If your mother is asking you what day it is, it could be because she’s worried about missing an appointment or concerned about something that should be happening. In that case, you could remind her that today is Monday, and that today you will be going to the grocery store and other shopping while Wednesday is the day you’re going to the salon. Even if you don’t know or understand the reason why the repetitive behavior is occurring, you can reassure your loved one, addressing and validating their feelings – this can be enough to calm and comfort them.

Keep a consistent routine.
Having a set routine that you stick to will help keep your loved one at ease and may reduce the amount of repetitive behavior he or she engages in. Having memory aids around the house where your loved one can see them will help to orient them and give them some comfort. Consider large clocks, calendars, signs and notes so that your loved one can get the information they need without having to ask you every time (this also has the benefit of helping them feel useful when they can accomplish the task themselves).

Redirect your loved one’s attention.
If the repetitive behavior is becoming too much or if you feel yourself getting overly frustrated, distract your loved one with another activity or topic of conversation. If you mother keeps unloading the dishwasher (that hasn’t been run yet), have her help fold laundry or do something else that will make her feel useful. Breaking the cycle, so to speak, may help get your loved one out of their rut.

Look for patterns.
Are there particular times of day when your loved one’s repetitiveness becomes worse, or are there people or events that seem to trigger it? Is there a common theme to their questions? Make note of when things seem to get better or worse, and adjust your loved one’s environment accordingly.

Most of all, do your best to stay patient, calm and positive. Never argue or try to use logic with your loved one, because that simply doesn’t work due to the nature of disease. That’s an important point to remember: this is a symptom of your loved one’s disease, not a reflection who your loved one is as a person. Remember that he or she can’t help the way they’re acting and they’re probably frustrated and upset, too. By reassuring them that you care, you’ll be able to give them – and you – a better quality of life overall.

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Offering Assisted Living, Enhanced Assisted Living, Memory Care, Skilled Nursing and Rehabilitation, The Reutlinger Community provides a continuum of care that allows seniors to live a life-enhancing and stimulating environment. Located in Danville, California, The Reutlinger Community’s newly renovated, 110,000 square foot community combines the comfort and familiarity of home with seasoned senior care and skilled nursing specialists to suit any seniors needs, allowing them to live the life they choose with freedom and security.

Because we specialize in a continuum of care, our residents never need to worry about leaving the community they call home or wonder what will happen when they need some more care. Residents and families alike can have peace of mind knowing that there are full-time licensed nurses available, along with activity coordinators, social workers, caregivers, a concierge and Rabbi who focus solely on helping each resident thrive. Even better, our services and amenities are equal to those of a state-of-the-art resort. This is the lifestyle and care that your loved one deserves.

At The Reutlinger Community, seniors have numerous opportunities to engage in award-winning programs that are designed to engage the mind, renew the spirit and provide opportunities to meet new people and learn something new. Whether residents are enjoying our art program and museum, listening to a lecture or educational program or attending spiritual programming and our wide range of activities, there’s something for each resident to love. Participate as much or as little as you like, the choice is all yours.

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