Repetitive Questions and Actions

When a person has dementia, most often the purpose of a repetitive question is not to seek information or an answer, but to seek reassurance.  Reassurance can be one good way to manage any difficult behavior including repetitive questions.  The behavior is often due to anxiety or fear, and we need to be sensitive to their emotions.  By understanding the reasons behind repetitive questions and actions, you can help provide comfort while preserving your own sanity.

It is important to know that your loved one has no intention of annoying you or pushing you to the brink. A continually repeated question doesn’t mean that they are not listening to the answer. Instead, repetition may be a sign of their insecurity and uncertainty which is often caused by memory loss. But there are other reasons for repetitive questions and actions.  For example, your loved one is unable to store or retrieve information, he or she is unable to judge time, and scheduled events are anxiety-producing.  Things like a doctor’s appointment, going to visit relatives or friends, holiday events, etc. all can trigger repetitive behaviors.  People with dementia often crave routine and consistency in their world, which is not always possible in the real world.

How should you respond to the repetitive questions and actions?

• Focus on the emotion rather than the question or action. Instead of simply answering the question reply with words of comfort. When your loved one repeatedly asks you who you are or asks for a long-deceased relative, it may be out of worry that there is nobody to care for them.  Assure them that they will be taken care of, they are safe and they will not be alone.  Maybe add that there will be plenty of food.  Try redirection, such as taking a walk together or another pleasant diversion.
• Be aware of your tone of voice, body language, and facial expressions.
• Try to remain calm and be patient.
• This may be the tenth time you are hearing the question, but realize that for them, it is the first time they are asking it. Answer the question the same way each time it is asked. Do not say, “that’s the tenth time you’ve asked me that question!”  If you get angry, this seems inappropriate to them and they could become more upset.  After all, in their minds, they only asked a simple question.
• If the repetitive action (such as folding the same clothes over and over) isn’t hurting anyone, don’t fix it. It may make you sad to see your loved one spend the morning folding the same towels, but to them, this could be a meaningful task and make them feel useful.
• Keep a log to determine if the question or action occurs at a certain time of day or night, or whether a particular person or event seems to trigger it.
• Use memory aids. Offer reminders by using notes, calendars, photographs, etc. If they ask you repeatedly when dinner is, give them a note that says, “Dinner is at 6:30 pm”.  You might even say, “It sounds like you are hungry or thirsty” and offer a light snack or glass of water.
• If they are pacing in the dining room or walking into a corner and unable to turn around, you can help break this pattern of behavior with reassurance and guidance. Instead of saying, “stop walking around the dining room” suggest that the two of you take a walk together.  Or you can try redirection with food, a beverage, or other activity.
• Some people with dementia use repetition as a way of keeping a conversation going. They want to “connect” with you and this is the only way they know how.  They sometimes may even constantly repeat what you are saying.

Attending or participating in a memory support group is very helpful in finding ways to cope with different behaviors.  It helps to know that you are not alone and that others are coping with the same situations that you are facing.  Accept the repetitive questions and actions as part of the disease.  Once you accept a “new normal,” you can become more understanding and less frustrated.  You have entered a brave new world, the world of dementia.

Written by: Linda Bliss, RN