II have often thought that caring for someone with dementia is the most rewarding – and most difficult thing a person can ever do. All facets of dementia care require an extraordinary amount of patience, especially when it comes to repetition, or repetitive behaviors.
I will never forget a time when I was working in memory care in the St. Louis area. I was accompanying the residents on a scenic drive, sitting next to the most lovely lady. We were barely leaving the parking lot of the community and she asked me, “Where are we going?”
I smiled and responded, “To see the eagles in Alton.”
She smiled in return and nodded.
One minute later she turned to me and asked, “Where are we going?”
I smiled as though it were the first time she asked the question and responded, “To see the eagles in Alton.”
Every minute for the next half hour, she repeated the same question – over and over, and new to the field of dementia care, I patiently answered each time. But I was secretly relieved when the drive was over.
It’s very common for a person with dementia to do or say something over and over — repeating a question, or word, or a physical motion or activity. As with all behaviors, it’s important to remember that the behavior you are seeing is a result of damage to the brain, and that the person is not intentionally trying to be difficult. In most cases, he or she is probably looking for security and comfort.
Causes of repetitive behaviors
Dementia is caused by damage to the brain cells. This often affects short term memory, in some cases very severely. In the case of repetition, the person may not remember that they just asked a question or completed a task.
Dementia also affects the individual’s ability to express their wants, needs, distress or discomfort through words or logical speech. Therefore the person may be trying to express a need, pain or distress, or be feeling fearful, frustrated or anxious – and it comes out as a repeated question or word because that is all they are able to do.
How to respond
Take a deep breath before you respond. Remember that the person is living with damage to the brain and they are not trying to be difficult or frustrating. Try to put yourself in their shoes and respond with empathy.
Don’t try to “fix” the person. Your role is simply to respond with patience and try to discover the need. Reassure the person that you are there to help.
Don’t correct the person or remind them that the just asked you that, or just told you that. It will only further their distress.
Look the reason behind the behavior. Check for physical needs first – pain, hunger, thirst, discomfort, restroom needs – try to meet those needs first. Check for patterns. Does the repetition occur at a certain time of day or with certain people?
Focus on the emotion, not the behavior. Rather than reacting to what the person is doing and trying to fix it, think about how he or she is feeling and what need they may have.
Provide an answer if possible. Give the person the answer that he or she is looking for – several times if necessary. If the person with dementia is still able to read, it may help to write the answer down and tape it to their walker, door, table, or other visible location.
Once you have met potential needs, focus on redirection in a positive way. Engage the person in an activity. Many behaviors are a result of boredom or lack of purpose. Ask the person for their help with a task or go for a walk. Give them something to hold or do with their hands. Offer a snack or beverage. Try guiding them to listen to music through headphones. Ultimately, you may need to accept the behavior; if a behavior isn’t harmful, it may be best to simply find ways to work with it.
Take a break. Even the most patient person can become exhausted with repetitive behavior. This doesn’t mean you are a bad person, it means you are a human person! Ask other family members for help; prepare them and give them tips for responding to repetition. Consider respite care or adult day when possible. If you can’t physically leave, step into another room and have a comfort moment for yourself – a small thing, beverage, song, prayer, text to a friend – something that brings you peace and joy.
As with all behaviors, it’s important to remember the behavior you are seeing is a result of damage to the brain, and that the person is not intentionally trying to be difficult. In most cases, he or she is probably looking for security and comfort.
Lean into support
Caring for someone with dementia can be incredibly taxing and stressful. Check your local community for a support group or join one online. Learn more about caring for yourself as a caregiver and ways to minimize stress.
