Caring for a family member living with dementia can be both rewarding and challenging. One of the common challenges that family care partners face is managing repeating behaviors exhibited by their family member living with dementia.

Repeating phrases, questions, or actions can be frustrating for both parties; however, there are strategies that care partners can employ to help reduce repeating and create a more supportive environment for the person living with dementia.

Dementia-Related Repeating: What is It

Before diving into strategies, it’s essential to why the repeating is happening Sometimes we refer to this as the “triggers”. Common triggers of repeating behaviors in individuals living with dementia may include:

• Inability to remember that they already asked a question: Memory loss, a hallmark of dementia, can lead individuals to forget that they have already asked a question, prompting them to repeat it.
• Anxiety about what is happening: Feelings of anxiety or uncertainty about their surroundings or circumstances can contribute to repetitive behaviors as individuals seek reassurance or understanding.
• Feeling a sense of loss of control: Dementia can cause individuals to feel a loss of control over their environment or daily activities, leading to repeated attempts to regain a sense of agency.
• Inability to judge time: Difficulty understanding the passage of time can result in repeated questions about upcoming events or concerns about when certain tasks will occur.
• Fear of separation from the care partner: Individuals living with dementia may experience heightened fear or anxiety when separated from their primary care partner, leading to repetitive behaviors as a way to seek reassurance or maintain proximity.
• To seek attention: Some individuals may engage in repeating behaviors as a means of seeking attention or connection with their care partners or loved ones.
• Side effects from medication: Certain medications prescribed for dementia or other co-occurring conditions may contribute to repetitive behaviors as a side effect.
• Inability to express other needs: Individuals may repeat themselves as a way to communicate unmet needs, such as hunger, thirst, or the need to use the bathroom.

Strategies to Help Caregivers

When we think about how to address repeating, we want to think about both how to prevent the repeating from happening and also how to respond to the repeating when it does happen.

It can be extremely helpful to consider what the possible triggers or causes are and then match strategies to reflect the specific needs of our family member living with dementia. Some examples of strategies that can help reduce repeating include:

• Acknowledge, Reassure, Redirect: Instead of becoming frustrated or correcting your loved one, acknowledge and validate their concerns or feelings, reassure them that you are on their “team” and redirect the conversation. For example, if they repeat something like, “I want to go home”, you may respond by saying something like, “I know you want to go home. You’re safe with me, I’ll stay here with you. Right now, I need your help folding these napkins”
• Create, Routine, and Structure: Establishing a consistent daily routine can help reduce anxiety and confusion, which may contribute to repeating behaviors. Stick to familiar schedules for meals, activities, and rest, providing a sense of predictability.
• Use Visual Cues: Visual aids such as calendars, clocks, and reminder notes can help individuals with dementia orient themselves to time, reducing the need to repeat questions about upcoming events or activities. For example, if your family member is repeating, “When is my daughter coming home?”, you may be able to leave a note on the coffee table or on a whiteboard in front of her that states, “Hi mom, I’m at work now, and I’ll be home soon! Love, Sarah” The care partner can then provide your family member with this note regularly to reduce her anxiety.
• Provide Distraction/Activity Engagement: Engage your loved one in activities or tasks that capture their attention and divert their focus from repetitive thoughts or behaviors. Offer activities that align with their interests, roles, and abilities, such as puzzles, crafts, or listening to music.
• Create a Relaxing Atmosphere: Adapt the environment to promote a sense of calmness, which may decrease the frequency of repeating behaviors. This may include turning the television off, playing calming music, or removing items in the environment that cause distress.
• Address Unmet Needs: Regularly check in with the person living with dementia to assess their needs and address any physical discomfort or emotional distress promptly. Be attuned to cues that may indicate hunger, thirst, or the need to use the toilet, and respond accordingly.

Help for Seeking Support

Caring for a family member living with dementia can be emotionally and physically demanding. It’s important for family care partners to prioritize self-care and seek support when needed. Connecting with support groups, online forums, or local resources like aging life care professionals for care partners of individuals with dementia can help.

Seeking guidance from healthcare professionals, such as doctors and occupational therapists can also provide valuable insights and assistance in managing repeating behaviors.

Repeating Behaviors Due to Dementia: Summary

Reducing repeating behaviors in individuals living with dementia requires patience, understanding, and creative strategies tailored to each person’s unique needs.

By addressing common triggers, validating emotions, establishing routines, providing opportunities for activity engagement, and addressing unmet needs, family care partners can create a supportive environment that promotes well-being and enhances quality of life for both themselves and the person living with dementia.

Remember, each person’s journey with dementia is unique, so it may take time and some trial and error to find the most effective approaches for reducing repeating behaviors.

 

Contributed by:

Rachel Wiley, MS, OTR/L, CDP

Rachel Wiley, MS, OTR/L, CDP is an occupational therapist and the founder and owner of Day By Day Dementia Consulting, through which she provides virtual consultations to family care partners of people living with dementia throughout Pennsylvania, New Jersey, and Vermont. In addition, she is the founder and owner of the Dementia Collaborative LLC. Rachel is certified in Skills2Care® for caregivers of individuals living with dementia, and she is a Certified Dementia Practitioner.

Also, Rachel is a certified master trainer of Skills2Care® through Jefferson Elder Care and trains occupational therapists from around the world in the Skills2Care® program. She is also currently a volunteer advisory council member for Dementia Society of America.

Previously, Rachel was an adjunct faculty member in the occupational therapy departments at Thomas Jefferson University and Temple University. She also worked as the occupational therapist and Dementia Service Coordinator for the Pew Charitable Trust Grant with Jefferson Elder Care.

Rachel attended Penn State University for her Bachelor’s in Rehabilitation and Human Services and minor in Psychology and attended Thomas Jefferson University for her Master’s of Science in Occupational Therapy.

She previously served as the Gerontology Chair for the Pennsylvania Occupational Therapy Association’s (POTA) District V Board. She also owned and operated a patient care practice, Day By Day Home Therapy, for 6 years, serving clients living with dementia and their care partners in the Delaware Valley.

 

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