If I’ve Told You Once, I’ve Told You a Thousand Times

Stop me if this gets annoying: What are we having for lunch today? When are we having lunch? What are we having, though? And when are we having it?

I joke, but for anyone living with a person with a memory problem, it’s not funny. “If you’ve already said, ‘cheese sandwiches’ five times, then two minutes later they ask again, repetitive questions can drive you absolutely nuts,” says Adriana Shnall, a social worker with the Baycrest Brain Health Centre in Toronto.

“In an ideal world, the caregiver will keep answering, not lose their cool and stay nice and polite. But that’s not always going to happen.”

Coping Strategies

Listen Carefully

Make sure you’re actually listening. “If they can’t remember that they just asked the question, that’s a memory problem,” says Shnall. “This is different than obsessive questioning, where they remember the answer but they’re not satisfied with the answer.”

An example of the latter might be an upcoming visit to the doctor’s. In this case, questions like “When are we going to the doctor’s? Are we going soon?” might be anxiety. But “most repetitive questions from a person with Alzheimer’s are due to memory problems,” says Shnall.

Answer the Question

“Initially, answer the question, whatever it is,” she says. Sounds easy, but a caregiver should be sure they have given a clear and correct answer—a few times, if necessary.

When it’s the fifth time fielding the same question, caregivers can get irritated. They may be tempted to give a different answer—or different answers—in hopes of getting a different response. This isn’t helpful, she says. Not only can this lead to further confusion, it’s “a bit nasty.”

Equally unkind is keeping count of the number of times the same question is asked. “People suffering from Alzheimer’s don’t have the insight to benefit from that,” says Shnall. While they might forget the question, they retain feelings from your scolding. “They won’t know why they feel bad, but they still do.”

Change the Dialogue

If repetitive questions are testing your patience, the most effective strategy is to change the conversation. A simple observation can be enough. “Say, ‘Oh look, it’s snowing outside! Why don’t you come to the window?’” suggests Shnall.

Relocate

Often, a change in locale—for example, a move to the living room from the kitchen—is enough to put lunch out of mind. “Now they’re not thinking of food, just because they’re not sitting in the kitchen.”

A Grander Scale

Caregivers should try to keep someone with Alzheimer’s engaged. “If they’re sitting there all day watching TV without much going on, it’s no wonder that lunch is such a concern,” says Shnall.

Physical exercise can make a big difference, too. “People who are not physically tired will dwell on small things,” says Shnall. A brisk walk, for those who are still mobile, and some fresh air can work wonders.

Care for Yourself, Too

“Caregivers need to know that it’s very normal to get frustrated,” says Shnall. If something’s getting on your nerves, walk away. “A count to ten and cool down works best for most people.”

Caregiver aid; communication cue cards: caregivercards.biz

Look for patterns. Keep a log to determine if the behavior occurs at a certain time of day or night, or whether particular people or events seem to trigger it.
Keep track so you can tell whether your loved one might be hungry, cold, tired, in pain, or in need of a trip to the bathroom.
Check with the doctor to make sure your loved one isn’t suffering from pain or the side effects of medication.
Speak slowly and wait for your loved one to respond.
Don’t point out that he or she just asked the same question.
Distract him or her with a favorite activity.

Use signs, notes, and calendars to help decrease anxiety and uncertainty. In the early stages of Alzheimer’s, when your loved one can still read, he or she may not need to ask about dinner if a note on the table says, “Dinner is at 6:30 p.m.”

–from the Alzheimer’s Association and Family Caregiver Alliance

Rosemary Counter is a Toronto reporter and screenwriter