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Dementia: How to Cope with Repetitive Questions.

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    You try to be patient. You really do. But a loved one’s memory loss can be so frustrating. Just ask any family member of a dementia patient.

    A woman being pushed in a wheel chair

    They really aren’t trying to drive you crazy. They aren’t even aware that they’ve asked you the same question 3 times in 10 minutes or told you the same story over and over. And over. You want to be kind and calm, but you’re also human. So, what do you do when you can’t answer the same question one more time?

    Take heart. ♥ There are ways to cope with this predicament. The sad fact is dementia isn’t going to go away, and will, in fact, get worse. Since your loved one isn’t capable of change, guess who’s going to have to adapt? Think of it this way: if someone in your family broke their arm, you wouldn’t insist they carry in the groceries from the car. More likely, you would prop them up with pillows and cut their food into bite-size pieces. You would adjust to their capabilities.

    The same is true of loved ones with dementia. As the disease erodes their capability to find words and build short-term memories, you, as a caregiver, must adjust. Your loved one still wants to communicate, it’s just going to sound differently. The tips below have helped me to think differently and stop stressing out about repetitive questions.

    You, first.

    Your body language will set the tone for interactions with your dementia patient. If your body is tense and you greet your loved one through gritted teeth, they are going to pick up on that. I understand that you’re upset because it is noon and they’re not dressed, plus the kitchen is a mess. You’re loved won’t understand but they will pick up on your tension and become unsettled or anxious that you’re mad at them. This is not going to help you get things done in the long run. Relax your shoulders, unfurrow your brow and breathe.

    Deep breathes. I really mean this. Take a deep breath from your diaphragm, exhale slowly. Repeat 3 times. Cleansing breathes will lower your stress level so when you’re loved one wants to know what time lunch is (for the fourth time today), you start from a calmer place. I think stepping away for a drink of water and a breathing break is always a good idea.

    Communication, second.

    It wasn’t until recently that I realized I needed to change my communication style because of the disease. Answering the same question again and again in an increasingly irritated manner was not working. Surprise. I remember my loved ones as they were – busy, capable adults and I still expected them to act like that. Sadly, dementia changes all that. My perception had to catch up with reality. Once I opened my eyes to what was really going on, I could focus on their abilities, instead of what was lost.

    I like to think of the repetitive questions as clues to what my loved ones are really trying to communicate. Dementia changes their ability to say what they really want to but they’re still trying, it just comes out in a different way.

    Here are some communication methods that have helped me:

    Initiating conversation.

    Your loved one wants to be social, just like the rest of us, but might be unable to develop a conventional conversations starter like “Do you think it’s going to rain this afternoon”. Still, they know if they ask a question they will get a response. Therefore, you get “what time is it?” again and again.

    Asking a question also lets them be in charge of the conversation. If much of their time is spent in assisted living or with home care providers, a lot of what they do is respond to instructions. “It’s time for a shower”, “I’m here to tidy up” “Try to eat some breakfast”. Maybe your loved one is really asking for their chance to talk.

    Look beyond the question.

    When answering, be reassuring, deal with your loved one’s emotions. For example, your mom asks you repeatedly what time you are coming over on Saturday. You’ve told her “noon” at least 15 times, but it doesn’t seem to stick.

    What is this question really about? Maybe she’s anxious about being ready on time, maybe she knows you’re coming over, but not why. So a better answer would be, I’m coming over at noon so we can go to lunch. Then you can talk about places you want to go to. You can ask about anywhere else she needs to go while you are out. At the end of the conversation, you can reassure her that you will call her when you are leaving to get her so she can be ready.

    Repeat their words, so they feel heard.

    “You want to know when I’m coming over on Saturday.” or “You want to know about the plans for Saturday.” It will be reassuring to them to understand. at an emotional level, that you heard their concern. This is better than snapping out “noon” in an exasperated manner. “Noon” answers the question but doesn’t meet the need.

    Good days/ bad days.

    Realize your loved one can be functioning at different levels on different days. Lots of factors can influence memory – a bad night’s sleep, new medication, too much stimulation like around the holidays, illness. I’m still surprised by this. One day your loved one seems pretty good and two days later they don’t seem to be functioning at all.

    Watch for visual cues.

    Not all communication has to be verbal. On bad days, when they’re forgetting words and losing their train of thought, watch their hands. If they’re saying I had to go to the place, and acting out eating motions, you can guess they want to talk about the cafeteria, or maybe the grocery store.

    Soothing words.

    Imagine the frustration for your loved one trying to communicate and not finding their words. You can say, “I know this is hard”, “I’m sorry you’re having trouble”. If they lash out at you, say “I’m trying to help”, in a calm voice. It’s a way to acknowledge the large, forgetful elephant in the room. Develop a “we’re in this together” mentality so loved one doesn’t feel isolated and embarrassed.

    Use their name.

    Sometimes when dementia patients seemed trapped in their mind far away, using their name will snap them out of it. I find this helpful when I’m getting the same question every minute of two. Before I answer for the third or fourth time, I say their name with a little bit of urgency, and it gets their attention. Make eye contact and then answer their question while they are present.

    Managing the environment, third.

    Limit noise/ distractions.

    This is fairly obvious. If your loved one has a hard time focusing/ remembering, don’t make it any harder than it has to be.

    man looking at a calendar

    Write it down.

    I’m still a fan of the wall calendar. Writing things down on your loved one’s calendar can help. Then, when they ask what day something is happening, you say, “Look. You have it right here on your calendar.” I believe it’s best for them to write it down themselves so they feel more in control. As you look at the calendar and discuss what’s there, your loved one is receiving information two ways, by hearing and sight.

    As the disease progresses, posting a daily schedule can be helpful as well as sticky notes or reminder signs placed around their living space.

    Judicious use of timing.

    You know you need to start planning for birthdays and holidays in advance. However, the sooner you let your elderly loved one in on the details, the longer you will be repeating these same details over and over.

    This is another casualty of memory loss and you have to find your balance. One the one hand, you want to share the fun details. On the other hand, the longer you wait to share, the fewer the number of times you will have to repeat the fun details.

    Redirect.

    I like this technique to combat the stories that have no end. You’ve heard the story of their neighbor’s comings and goings 3 times in one morning and you just can’t hear it one more time. Maybe it’s time to move into a different room where the neighbor’s home isn’t visible or make some coffee as a distraction.

    Triggers.

    This is similar to the “downsizing” concept that if an item doesn’t bring you joy, you don’t have to keep it. With dementia, if an item triggers confusion or sad memories, hide it or get rid of it. For example, if you’ve kept the leash that belonged to your deceased dog, it can trigger confusion when your loved one sees it in the garage. Is it time to walk the dog? Did we lose the dog? What is going on?

    Similarly, if you have a knick-knack that a friend gave them, a friend who can’t drive anymore, it might be kind of you to replace it with something else. If it triggers sad feelings, “why haven’t they been here”, and you don’t want to talk about it for the 100th time, sneak that knick-knack into a drawer.

    Final tip:

    If nothing else, you can be grateful for what you have. Maybe your loved one is telling you the same story at dinner that they told you on the phone that very morning, but at least they know who you are and remember what happened. If you’re at the dinner table, you are not visiting them in the hospital after a fall, be thankful. Finally, you don’t have to be perfect. Caregiving for dementia patients is tough and you are a good person to help in the way that you do. Your loved one would thank you if they could.

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