It is early morning and your loved one with dementia has already asked several times, “Am I seeing the doctor today?” Your patience is wearing thin. Why is she asking this? How can you answer her question satisfactorily? Is there anything else that you can do to help her?
Why People with Dementia Repeat Questions and Stories
Repetitive questioning or storytelling occurs due to impaired memory, and it is a common symptom of dementia. It is caused by the person’s difficulties with picking up on new information, retaining it, recalling it, and due to their inability to differentiate between past and present experiences.
Your loved one may repeat a question for several reasons, but a common manifestation of dementia is that something has triggered them to focus on a particular situation or concern, and this may heighten their anxiety or agitation. On the opposite end of the spectrum, they may also repeat a story from their past because it feels familiar and soothing.
The one that you care for may not remember that they just asked the same question, or told the same story, and they may continue to repeat it because their basic human needs (i.e., safety, connection, identity, autonomy, and comfort) are still a part of who they are despite any level of dementia.
What You Can Do or Say to Help
As caregivers of people with dementia, we understand that repeated questions can add challenges to your day. It requires a dose of extra patience, as you know your loved one is not asking questions just to be obnoxious.
It is easy to respond to repetitive questions with “You just asked me that,” but, this reply is of no help. Your calm response and gentle touch are reassuring to your loved one that you care, even if they have already asked a question more than once.
To truly help, you must dig into the whys. Why are they asking?
Related: How to communicate effectively with a patient with dementia
Identify Potential Triggers
Identify and address potential triggers that can lead to repetitive questions. Start this process by answering two questions:
- Is there anything in your loved one’s environment, routine (or lack of routine), or physical health that might trigger them to repeat a question?
- Is there a common theme to their questions?
Using the question, “Am I seeing the doctor today?” here are some common trigger points and strategies to try:
Pain or discomfort (feeling unwell)
The patient may be unable to articulate that they are not feeling well, but memory serves them that they need to see a doctor.
Ask the patient if they are feeling well. Ask them specifically if they are feeling any pain or irritation in their body. Consider bringing in a doctor or nurse to rule out any medical issues.
Boredom
The patient may need a change in routine. They may need to go on an outing or participate in activities to break any monotony that they may be feeling.
Engage your loved one in activities such as crafts, games, get-togethers, or time with others. If possible, get your loved one out into the community. Fresh air and a change of scenery do a world of good for everyone’s mental health!
An image or similar object or person
The patient may see a doctor in the hallway, or his or her name on a calendar, a business card, or a physician or nurse on television, which triggered them to think about their next doctor’s appointment.
Consider giving your loved one a calendar marked with appointments or special events. This can help eliminate confusion and questions.
Fear works similarly. Your loved one may see a fire depicted on a news channel, or in a traumatic movie or television show, or she may stare at the fire exit sign leading her to ask questions such as, “Where is that water hose?” or “Is the fire department coming?”
Remove objects or move things around to change what is in the patient’s field of vision.
Avoid television or movies that trigger fear or anxiety in your loved one.
A change in medication or the person administering it
Your loved one may not be able to think the entire process through (i.e., the medicine looks different…or this person administering my medication is someone new), but their brain associates medication with their doctor.
Explain to your loved one that the medication may look different, or that the person giving them the medication is different, but everything is prescribed by her very own doctor, and that she is safe because of him or her.
Pay Attention to Emotions
Is your loved one experiencing anxiety, sadness, or depression? They may not be able to tell you that they are sad, but they may often express it through repeated actions and words.
Encourage these things to discourage anxiety, sadness, or depression:
- Memories. The reminiscing of memories can boost a sense of joy, even if it leads to repeated stories in a dementia patient. Encourage the sharing of joyful stories.
- Emotional connections. Human connections are vital to mental well-being. Ensure the one that you care for has people that they can connect to, and bond with, in their life.
- Productivity. Involve your loved one in activities that boost a sense of productivity and autonomy.
- Routine. Establish a daily routine to ward off anxiety.
Answer with Different Modalities
Some of us learn better through reading, pictures, or audio. When a dementia patient repeats the same question, it can indicate that they do not understand your answer.
Try using more than one sensory modality to answer and avoid repeated questions. Use a picture, a drawing, a recording, or written words to answer their questions. Display these items prominently in front of the patient.
Seek Help and Take a Break
As a caregiver, it can be difficult to admit that you are tired or feeling frustrated. One of the best ways to help yourself can be to speak with others who understand.
You may also need to take a break. Consider an hour a day, or perhaps once a week to catch up, take a breather, and return to caretaking with a refreshed mind.
We have created a Respite Program to give caregivers a needed and welcome break. If you are seeking help a few hours a day or just a few days a month, we are here to help.
When we care for ourselves, we can care better for our loved ones.