Your mom or dad may repeat the same actions over and over. Mom may ask the same questions. Dad may continuously tap his leg or pace the room. They may repeat actions or questions without realizing that they had done the same thing moments before.
Behaviour like this can be frustrating for the caregiver. After you have answered the same questions multiple times, your patience can wear thin. It is important, however, to remember that disease is causing this behaviour not individual choice. Your mom is not repeating questions just to get under your skin.
Understanding the Cause of Repetitive Behaviour
When repetitive behaviour occurs try to discover the reason for the repetition. Usually there is an underlying anxiety that is driving this behaviour. As well, the time of day may have an impact. For example, late afternoons can be times of heightened anxiety for some individuals.
Challenging behaviour at the end of the day is referred to as sundowning. Individuals can become highly agitated and that can manifest as repetitive behaviour. While sundowning may be attributed to various causes, one possible cause is a lack of sufficient stimulation throughout the day. Ensure that your mom or dad has sufficient physical and mental exercise to bring them to the end of the day pleasantly tired.
There may also be a level of anxiety that comes to the forefront during certain sequences of events. For example, transitions can cause anxiety. Moving from a sitting room to a dining room, or from one activity to another, can cause unease. When it is difficult for an individual to process information or to express their emotions, their anxiety may exhibit as repetitive behaviour.
Identifying Triggers for Repetitive Behaviour
Repetition is usually caused by short-term memory issues but there are other contributing factors that may play a role. If you are experiencing repetitive behaviour with your loved one, ask yourself these questions:
- Are there a lot of different noises and competing stimulation in their environment? Alternatively, is there not enough stimulation?
Stimulation can be overwhelming and lead to sensory overload. This can cause the individual to find comfort in repetitive behaviour. Assess the situation and either increase or decrease the amount of stimulation as appropriate.
- Are there separation issues? Does the individual feel anxious about being separated from their primary caregiver?
Pay attention to whether the individual feels secure in their relationships with those they care about. Even though dementia is affecting the cognitive capacity of your mom or dad, they will still need to know that they are loved. When you are with them concentrate on giving them positive reinforcement and lots of affection.
- Are they feeling a loss of control and is that leading to a need for increased attention? Some repetitive behaviours may be a cry for attention.
The need for attention can be significant at this time in their lives. They may feel overwhelmed by the changes and need more attention, particularly if they are being transitioned to a new place of residence.
- Are their needs being met? Do they feel safe and secure in their surroundings?
While this whole time may be overwhelming to you, it is a good exercise to step back and think about how things look from your loved one’s perspective. They may have had their life change dramatically in a short period of time. This can negatively impact them and give rise to repetitive behaviours.
Reacting to Repetitive Behaviour
When faced with repetitive actions, turn the action into an activity. For example, if they are playing with their hands, offer them a cloth to dust with.
If they are asking repetitive questions, remain calm and be patient. They may not be aware they are being repetitive because they will not remember that they just asked that question. Continue to answer their questions and even write out some of the information that they are concerned about. Above all try to not convey frustration or anger as it will increase anxiety levels and fuel the repetitive behaviour.
Try and understand the emotions behind the repetitive behaviour. Remember that emotional memory is very strong and responding to the underlying emotions will be the most effective way of mitigating this behaviour. Your loved one may feel lonely or anxious, so a gentle hug conveying affection may be very effective.
Engaging them in activities that focus them away from their emotional state is also helpful. Listening to music or playing a game can be just the change in emphasis that they need.
Nicole has trained hundreds of professional and family caregivers who have touched the lives of thousands of individuals living with a cognitive impairment. Nicole also holds a law degree from Osgoode Hall Law School, a Master’s in Law from Queen’s University specializing in Negotiations and is a Certified Professional Consultant on Aging.