How do I cope with constant repetitive questions?
I have been asked a question I couldn’t answer today by my neighbour who cares for her mother and a lady she cleans for, both of whom have memory loss.
Her mother repeated the same thing 10 times today and the lady she cleans for asked her the same thing 16 times last week within a matter of a few minutes.
My neighbour is not a qualified carer and admits that she lacks the patience that a full-time carer requires, but she said that she feels that she herself is starting to be very stressed by this constant repetition as she is herself trying to do other things, such as cleaning or focus on making doctor’s appointments for the ladies concerned.
She asked if there is a technique she could use, either to keep herself calm and less stressed or whether there was a distraction method to steer the ladies from their repetitive course of conversation.
Do you have any suggestions?
Please tell your neighbour that I really sympathise with her. My mother used to ring dozens of times during the day with the same question and unless you’ve experienced this it’s hard to understand just how frustrating it can be.
Much as we may know that repetitive questioning is a symptom of dementia and that we “ought” to be patient, we still get stressed out. If we try and answer the same question over and over again, the stress levels shoot up. If we snap or ignore it, we feel guilty. It can get to the point where it feels like the person is “doing it on purpose” to be annoying, even though we know logically that it’s part of their illness.
I think the first step towards coping is to realise that there is no “solution”. No matter what we do, the person with dementia will repeat themselves. But although we can’t stop repetitive questioning, we can try to understand why it happens and find different ways to react. This can reduces the amount it happens or at least lower the tension so it’s possible to concentrate on other things.
Why the constant questions?
So why do people with dementia ask the same question over and over again, sometimes within minutes?
- Memory loss. The simplest explanation is that they have forgotten that they asked the question. Or they may have forgotten the answer. Plus, if they have hearing loss, they might not have heard the answer properly.
- Anxiety. Sometimes, what sounds like a request for information is actually about an underlying worry. For example “What day is it?” could mean “My son always visits on a Sunday and I think I’ve forgotten to make lunch”.
- Confusion. “Is John back yet” might mean “Who will look after me now my late husband isn’t here?”
- Boredom. It may be that the person with dementia has been on their own or sitting doing nothing for a long time. They then seek attention, in the way a child does who wants something to do.
- Stress. If the environment is crowded, noisy, busy, the question “When are we going home?’ might mean “This is too much for me’”.
How to respond
Figuring out what the question means can be a guide to knowing how to handle it. With that in mind, here are some suggested ways to deal with repetitive questions. It’s hard though because dementia affects everyone differently and it can take a while to work out what’s best for any one person in a given situation, especially as the disease progresses.
- If at all possible, keep calm. Avoid shouting, getting cross or saying “I’ve just told you that”. It would take a saint not to do this sometimes but it increases the stress for the person being asked and the person asking the question, making it more likely that they will keep asking.
- Pre-empt the question, or the worry behind it. For example, if your neighbour knows there is anxiety about someone who isn’t there, she can keep saying “I am here, I am looking after you today.”
- Change the subject – just switch topics. Talk about something that happened during the day. Or point out the window and talk about what’s outside.
- Ignoring the question can work occasionally. Or your neighbour could try physical contact instead – maybe a hug or holding hands and just saying “It’s OK”.
- Take the person away from stressful, noisy or unfamiliar environments.
- If the questions are about day, time, place, try simple visual aids. A large calendar on the wall or prominent clock that shows the day, date and time.
- Try sticking notes onto objects explaining how things work, reminders of things to do, visitors who are coming that day.
- A simple family tree or photograph album with clear explanations can provide reassurance and orientation.
- Find the person asking the question something easy but useful to do. For example, while cleaning, your neighbour could ask for help with dusting.
Sometimes, it may be best just to answer the same question over and over again. In that case
- Speak slowly, loudly and clearly. Talk directly to the person.
- Answer very simply – just one idea per answer. There’s no need to tell “the whole truth and nothing but the truth”.
- Try to avoid answers involving logic or reasoning – they may not be able to understand this.
Avoiding stress and guilt
One of the hardest things about repetitive questioning is how bad it can make the listener feel. As your neighbour says, she may be trying to do other things at the same time. Or it may feel rude or disrespectful not to keep answering.
I think the most important thing here is to recognise that this is not a “normal” conversation and some of the ways in which your neighbour used to communicate with her mother and her employer no longer apply. She shouldn’t worry about being overly accurate or honest. If she is talking to her parent, it can be hard to take on board the idea that she is now “parenting” them.
- It may help your neighbour to slightly distance herself from the questions, disengage her emotions and just keep saying some stock phrases that reassure, whilst having her mind on something else.
- She can diffuse the situation by using humour or singing a song.
- If she feels particularly stressed, she should leave the room for a while or go for a walk.
- It’s important to get some “respite” from being a carer and not be afraid to tell someone trusted about how she’s feeling.
- It’s good to learn relaxation techniques like meditation, yoga or just deep breathing.
I do hope this helps. There are also a few articles on When They Get Older that might be useful for your neighbour and others who may struggling with the same issue.
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Dr Lesley Trenner is a life coach who specialises in supporting people with ‘ageing parent’ issues. She has 12 years experience helping individuals and organisations going through change. For more information visit Lesley’s website, send her an email or call 07919 880150.