How to handle repetitive questions from people living with dementia

Dear Carol: It’s still morning but since my mom has dementia and lives with me, I’ve already answered the same question five times. She’ll get stuck on one topic and can’t let it go. This week it’s, "Have we started preparing for Thanksgiving, yet?" I tell her no, it’s spring so it’s far too early, but she asks again ten minutes later. I understand this is caused by her short-term memory loss so at first, I’m pretty good about patiently answering. After a while, though, it really gets to me, and then my annoyance comes through in my voice. That makes us both feel bad. Any tips? – KS

Dear KS:  You know you aren’t alone, but I’m reminding you, anyway. Caregivers start out being kind, then continue with grueling patience, but eventually, some very human irritation can become evident. As with most dementia-care situations, it’s vital to stay calm and offer reassurance, but understanding what’s behind the behavior can also help.

Short-term memory loss is the most obvious reason for repeating questions, but anxiety, stress, discomfort, generalized confusion or even fear can contribute.

In the instance you mentioned, your mom is focusing on a traditional holiday that’s fixed in time. This might be her way of coping with the anxiety of being unable to remember the day of the week or even the current month, let alone a holiday that requires preparation. It’s also possible that she’s anxious about something unrelated, such as an upcoming medical appointment that you may have mentioned. Consider, too, that she may be anxious because she’s uncomfortable and can’t express what’s wrong. So, check that she’s not too hot, too cold or in pain.

No matter the underlying cause, your mom needs a response since being heard is reassuring to anyone. Perhaps you could give her a hug and say, “I’ve got Thanksgiving plans under control.” Keep your answer brief so she doesn’t get lost in what to her might just be a tangle of words. This approach helps you as well since it’s far easier than repeating long, reasoned explanations. Remind yourself that she simply needs reassurance, not details. Distraction can be helpful, too. You could just answer briefly as mentioned above and then say, “How about we watch some music videos, Mom?”

Alternatively, since the need to feel useful is human, you could tell her that she can help you get ready for tonight’s dinner by sorting the silverware, or she could fold laundry so that you can prepare the vegetables. Such simple, repetitive tasks could both soothe her and provide her with a feeling that she’s contributing, which would be a boost to her self-esteem. Engaging her this way might also give you a few extra minutes to step back and take some relaxing breaths.

Frazzled nerves are a human reaction to dementia care, KS. Longer breaks could increase your reserves, so, if possible, engage family members or hire help for a few hours a week to allow you time to regroup.