Mary asked the questions again and again while waiting for her lunch at a restaurant. Her eyes were fixed on the centerpiece, which included a printed list of the specials during the next three days, including Christmas. So every two minutes, she had the same request: “Please read me the menu. When is Christmas? When is Christmas?’’
Repetition is one of the common challenging behaviors of Alzheimer’s disease. Others include refusal, delusions (fixed, false ideas or beliefs), aggression, false accusations, wandering and agitation.
Behaviors like constant and repetitive questions can try family caregivers to the breaking point, Alzheimer’s expert David Troxel confirms. “It’s a long haul,” he said. “It’s not an acute illness – the average length is eight years, but people can live with it for 20.”
Following are approaches from Home Instead Senior Care network’s free Alzheimer’s Disease or Other Dementias CARE: Changing Aging Through Research and EducationSM Training Program to help families manage challenging behaviors like repeated questions:
• Redirect. The first time a question or concern comes up, take a few moments to answer the question fully and provide reassurance that all is well. If that doesn’t work, try to engage the senior in a related topic. For example: “Tell me about your favorite Christmas.” “What was your favorite present?” “How about your favorite Christmas meal?” “What holiday do you like best?” Sometimes discussing the topic (in this case, Christmas) a bit more will lead her away from the repetitive behavior and calm her anxiety.
• Utilize the person’s life story for ideas. The CARE program encourages caregivers to know seniors well. For instance, when a caregiver knows that the person loves country western music or enjoyed quilting, they can ask that individual about this new and favored topic to “change the subject,” but in a meaningful and respectful way.
• Physically move the items or senior from the environment. If the menu, in this case, or an object, in general, continues to agitate or irritate, remove the senior or the object from that situation.
• Offer simple choices. Persons with dementia still want to feel in control of their lives. The CARE program teaches that one way to break a repetitive question cycle is to offer a simple choice, “Speaking of Christmas, Mom, would you like to serve turkey or lamb this year?”
• Apologize and take the blame. Apologizing or taking the blame in a situation (even when it’s not your fault) diffuses many situations. In this case, the family member can apologize for not understanding her concern or question and then try to move Mom away from her anxiety about Christmas plans.
Alzheimer’s experts suggest that many challenging behaviors can be positively influenced by creative and well-informed caregivers. The Alzheimer’s Disease or Other Dementias CARE Training Program teaches techniques that can turn failure into success.
For more information about free Family Caregiver Training for family caregivers of seniors dealing with the behavioral changes of Alzheimer’s or other dementias, contact your local Home Instead Senior Care office, or visit HelpforAlzheimersFamilies.com to engage in an e-learning course.