In home care, a question I often get is how to care for someone with Alzheimer’s who asks the same questions over and over again. To better understand and manage what’s going on, it helps to first know a bit on Alzheimer’s disease and dementia.
Alzheimer’s is a type of dementia that affects memory, thinking, and behavior. It’s a progressive disease, where brain cells deteriorate and eventually a person can’t make sense of the world. When short term memory is affected, it can lead to repetitive behaviors, like stating or asking about the same things over and over. In essence, your loved one can’t recall having already asked a question because of their memory loss. A person with Alzheimer’s may be unsure of what’s around them, where they are, the passage of time, or recognizing anyone. All together it’s very unsettling, and a source of discomfort for them. Understanding how they feel, or describing their own feelings and needs, can also be lost in a person with Alzheimer’s disease.
Affected by these conditions, your loved one isn’t trying to be annoying, or repeating questions because they need information. They’re really asking questions because of feeling lost, stressed and anxious, and need reassurance. As a caregiver, answering these questions can be difficult, and wear out your ability to care for a loved one. To help, caregivers should be prepared with some basic knowledge and awareness on how to respond:
Keep it simple. Use short and simple responses. Reassure with a calm voice and gentle touch. Avoid complex explanations with multiple ideas when asked a question.
Physical. See if there is discomfort, pain, or something physical at the root of the cause. For example, infections or side effects from medications can also cause changes in behavior and awareness in older adults.
Realize it’s feelings. Know what triggers unpleasant feelings. For example, a lost sense of time can bring on anxious feelings. Try safe, repetitive, and soothing activities like sorting or folding familiar items, or dusting and wiping to keep hands and minds calmly occupied. Walks, listening to music, and looking at familiar photos or books can be pleasant diversions.
Change the subject. Sometimes changing the subject can shift one’s attention enough to have a calming effect. Asking a simple question can also shift a person’s focus in the same way.
Abilities. Check if you’re asking your loved one to do more than they’re able to. Accept your loved one as they are in the moment, and that they are doing the best they can.
Above all, take a deep breath, give your loved one a reassuring hug, and try to see behind the behavior and words repeated. It’s also vital to keep up your own health, and have a support system including the local Alzheimer’s Association chapter, family, friends, and faith groups. Addressing repetitive questioning in Alzheimer’s and dementia can be a trying experience. But with knowledge and awareness, these moments shared with your loved one can be the most precious of gifts.