Dementia

02 November 2007

How to deal with repetitive questioning

Repetitive questioning (repeated questions) can be tiresome and frustrating to families. Here are tips on how to cope with this.

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A person with Alzheimer’s Disease or other dementia may:
  • Repeat words or phrases
  • Repeat questions about the time of day, appointments or past events.
  • Tell the same story several times in a single conversation

Repetitive questioning (repeated questions) can be tiresome and frustrating to families. Even the most well-intentioned caregiver may feel overwhelmed at times.

Worse, people with Alzheimer’s Disease or dementia may become upset or angry when told that they are repeating themselves.

Understanding the symptom
Repetitive questioning is often misunderstood as a need for information. Recent medical studies have found that it is more often a need for reassurance.

Imagine how frightening and confusing the world would seem if you had difficulty understanding how one event in the day flows into the next. You may worry about the future if you could not process tasks in a logical sequence.

Repetitive questioning may indicate that your loved one is anxious. A person who asks the day or time, over and over, may need reassurance from you. With a ‘disconnect’ in their ability to remember times, dates and past conversations, your loved one may also need help understanding the order of activities, and to be reassured that you will not, for example, forget their next doctor’s appointment.

Doctor’s notes
Alzheimer’s Disease affects the ability to learn and to remember. Things that are just said, done or discussed are often forgotten within a few minutes. The symptom may worsen over time.

Repetitive questioning indicates impaired frontal lobe function. It is a very common complaint in all stages of Alzheimer's Disease, and one of the most stressful.

Repetitive questioning often responds to cholinesterase inhibition. Improvement in repetition usually goes with overall clinical improvement.

Managing repetitive questioning
This difficult symptom can cause the most loving caregivers to lose patience and feel “stressed out”. Before you reach the breaking point, try a few tips from DementiaGuide’s online resource for managing repetitive questioning:

  • Display the day. You can help your loved one to process information and understand what to expect from their day. You could:
    • Speak about the date. You can make it a habit to refer to the day and month every day. It may also help to hang a calendar by the bed or in the bathroom, and to remind the person to check off the days.
    • Display a daily schedule. You can try listing the day, date and planned activities or appointments on an erasable “whiteboard,” available at any office supply store. Your loved one can better understand their day if you discuss the daily schedule, as well as display it.
  • Change the subject. You can try changing the subject to a new topic. Could you share a story about their grandchildren or talk about a favourite pastime? Changing the subject might get their mind off of their question.
  • Identify the cause. You may recognise the underlying reason for their questions. Are they preoccupied with an upcoming event? For example, if they are asking what time it is, maybe they are anxious about being left alone. You can reassure them that even if you go out, a trusted visitor will stay until you get home.
  • Reduce confusion. You can track the repetition for a few days. Does it increase at certain times of the day or with the number of people around? If so, try to occupy them with new activities during those times of day, and keep the number of people to a minimum.
  • Schedule a break. You can reduce your own stress level by having a visitor, or watching a regular television show before you lose your cool. Don’t forget – you too may need support once in a while.

Additional resources
Steven Sabat. The Experience of Alzheimer's Disease. Life Through a Tangled Veil. (Oxford: Blackwell, 2001).

About DementiaGuide
DementiaGuide is a new Canadian technology designed for to help families living with Alzheimer’s Disease stay healthier, longer through symptom-tracking. It is the product of 10 years of clinical research by Dr. Kenneth Rockwood, internationally-recognised geriatrician and dementia specialist.

Repetitive questioning is one of 60 symptoms that can be managed with DementiaGuide’s online resource for caregivers. For more information on repetitive questioning, or to try it free for 60 days, please visit www.dementiaguide.ca.

For more information visit: Dementia SA: http://www.dementiasa.org/ or Alzheimer’s South Africa: http://www.alzheimers.org.za/

 

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