Responding to Repetitive Questions from Alzheimer's Patients

Throughout the stages of Alzheimer’s and other forms of dementia, caregivers are bombarded with repetitive questions from the patients. The questions have to do with the time of day, past events, future events, people who have died, stories they have told and have been told. The questions may be simple, but consider the quote below.

“Having to answer the same question over and over and over saps morale like few other aspects of the illness.” -- DementiaGuide

Based on studies done on the topic, DementiaGuide also mentions some important facts that caregivers should know:

  • Repetitive questions from patients are not always to seek information, but more often to seek reassurance.
  • Repetitive questions result not only from problems with memory, but also from problems with planning (example upcoming doctor’s visit or taking a trip).
  • People with dementia become upset when they are told about repeating themselves; and the repetition increases when they become upset.

With this knowledge, consider the following options as we discuss appropriate responses to repetitive questions. The Alzheimer’s TalkTactics is good to remember whether responding to or initiating the questions.

The Alzheimer's Talk Tactics

Source

(1) Speak Simple Statements

For a start, the caregiver helps the situation by responding with calm voice, pleasant facial expressions and positive body language. These dispositions may not lessen the questions, but they help to keep the mood manageable.

Speak a simple, clear answer. If the patient asks "Do you see my cane?" A simple answer is "It is leaning on your chair." There is no need to preface your statement with a reminder of how many times the patient has asked, or add instructions about putting it in the same place every time. Alzheimer's patients cannot handle information overload.


(2) Respond to the Emotion

Used by Permission
Used by Permission | Source

The caregiver who connects closely with the patient soon learns to read between the lines. For example:

  • Repeating the question, “Is my brother outside?” may mean that there is a longing to see the brother. Some comfort may be derived from an answer like, “Your brother misses you too; he is planning to come.”
  • “Where are my clothes?” may suggest fear that the patient’s personal belongings are being stolen. A good response is that the clothes are in a safe place where no one can steal them.


(3) Change the Subject

Another way to deal with repetitive questions is to distract the patient by changing the topic or introducing an activity. For example, when the patient asks for the brother, talk about something the patient likes that the brother brought on a previous visit. If the patient keeps asking for a brother who never comes, find a pleasant way to introduce one of the patient's favorite topics.


Photo by X posid
Photo by X posid | Source

(4) Avoid Visual Triggers

Sometimes the presence of an object in the room may trigger a question. In my mother’s case, it was her bag that she kept packed for years in case of a medical emergency.

Day after day, she asked, “Could you let me see what is in that bag?” At first, I complied, but after it got tiring for me to take it down from the top of the cupboard, stand and watch her unfold and then fold everything again, I moved the bag out of her view. Out of sight, out of mind.


(5) Avoid Correcting the Patient

If the patient keeps asking for baked chicken, there is no need to convince her how often she eats it. The question may be her cue to you that she is hungry, and she asks for it because it is her favorite food. The facts do not really matter if the caregiver will respond to the need underlying the question.


(6) Avoid Using Negatives

Negative words do not always get noticed, not even in sound minds. It takes extra effort for the subconscious to process them.

  • Question: " When are we going to have breakfast?"
  • Answer: "We never have breakfast before we shower." (The listener may hear, "We have breakfast before we shower.")
  • Next question: "We have breakfast before we shower?"

The confusion could be avoided with a simple, positive answer to the first question. "We will have breakfast after we shower."


Source

(7) Post Signs and Pictures

Every day my mother asks "Where is the bathroom?" With a bathroom sign on the door, sometimes I may get the opportunity to point to it before she even asks.

In the early stages of the disease, while the patient can still read and follow some directions, words as well as signs can be used effectively. The Alzheimer's Association also recommends a schedule (not too many details) which the patient can follow.

Both the caregiver and the patient benefit. Sometimes, the caregiver may want to carry on an activity instead of stopping to give a verbal answer; for the patient, it is a mental exercise to interpret the word or sign.


Common Response vs Recommend Response

(8) Repeat the Answer

Sometimes, the challenge is to practice patience and repeat the answer to the repetitive question. Carefully observing the patient may help the caregiver perceive that it is not always the same reason that motivates the question every time.

For example, it is possible for anxiety, boredom or curiosity to produce the same question, "When are we going to the party?". Repeating the answer with a different slant may satisfy different needs.

  • "We are going to the party at six o'clock and I will be with you the whole time."
  • "We are going to the party at six o'clock and they will play games that you like."


(9) Excuse Yourself

No matter how kind the caregiver is, workplace stress can takes its toll. When the questions become overwhelming, it is better to excuse one's self from the room, than answer with disgust. “Excuse me, please,” gives the caregiver permission to avoid further irritation of repetitive questions. After a brief break to exhale, the questions may have subsided; if not there may be renewed energy to cope.


References

Alzheimer's Association®: Training and Education Center, (Copyright 2016)

DementiaGuide Symptom Library: Repetitive Questions/Stories (Updated 02/23/2016)


(10) Respond to the Five Senses

People communicate through the five senses. When the Alzheimer's patient loses the memory, the senses are still pathways to the satisfaction of his physical, emotional and social needs.

Repetitive questions about the time to go home, and about siblings and deceased loved ones may indicate a longing for a familiar environment. Such longings may be satisfied with the sight and fragrance of familiar flowers; the taste and scent of a familiar food; the sound of familiar music; or the touch of arms around the shoulders, brushing of hair, or a long hug.

Through the caregiver's efforts to make the patient happy, many questions--some not even asked--may be answered with satisfaction.

© 2016 Dora Isaac Weithers

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Comments 60 comments

Ericdierker profile image

Ericdierker 9 months ago from Spring Valley, CA. U.S.A.

Wow this is interesting. I am not close to anyone with dementia, but I find your articles on the subject of giving them appropriate care to be life lessons as well. Thank you


MsDora profile image

MsDora 9 months ago from The Caribbean Author

Eric, so kind of you to read even though you are not closely affected by this situation. Thanks for your encouragement.


billybuc profile image

billybuc 9 months ago from Olympia, WA

Yes indeedy, Dora! I had no concept of the horrors of this disease until my best friend was diagnosed. Now, after six years of being with him, I am fully aware. Thank you for continuing to raise awareness.


denise.w.anderson profile image

denise.w.anderson 9 months ago from Bismarck, North Dakota

I am glad that you brought this up. I deal with it on a regular basis with my daughter who has disabilities. I have to look beyond her questions and solve the underlying need in order for the questions to stop. It takes a great deal of patience and kindness to answer in a loving way rather than getting upset with the repetitive nature of the questions.


Jackie Lynnley profile image

Jackie Lynnley 9 months ago from The Beautiful South

I love reading these about your mom as it brings back memories of my mom. Usually it makes me smile too even if it was an aggravating thing. Like some walking shoes I bought my mom she made me put up next to the TV so she could be sure no one stole them. I was pleased she loved them so much but of course I was the only one who could have stolen them although she was several sizes larger than me but that is the way their minds work. In fact my mom would sometimes talk about me to me. lol Believe me I would do it all over again in a minute! I do hope you get some time for yourself though.

God bless you sweet daughter and many hugs!.


MsDora profile image

MsDora 9 months ago from The Caribbean Author

Bill, it a privilege to have this connection with someone outside your home. Learning from a distance is a little less horrifying.


MsDora profile image

MsDora 9 months ago from The Caribbean Author

Denise, best to you and your daughter. By now, you can affirm that the patience and kindness you talk about come from experience. Thank you for your input.


MsDora profile image

MsDora 9 months ago from The Caribbean Author

Jackie, I also would like to read about your experience with your mom. I wonder if you ever thought to write about it. You always encourage me, and I appreciate you.


word55 profile image

word55 9 months ago from Chicago

You're just a sweet professional, Dora. You are doing your job so well and telling others how well it can be done. Be blessed!


FlourishAnyway profile image

FlourishAnyway 9 months ago from USA

My great grandmother asked repeated questestions and sadly her main caretaker at the time (my grandmother) was none too patient. Now it's my grandmother doing the repetitive questition asking and a whole host of other things, and the aunt that lives with her tries her best.


MsDora profile image

MsDora 9 months ago from The Caribbean Author

Word, you cheer me up every time. Thanks for your friendship and your support.


MsDora profile image

MsDora 9 months ago from The Caribbean Author

Flourish, so you know about the repetitive questions. They can be frustrating and they do test one's patience. Praying strength and patience for your aunt. Thanks for sharing.


Jackie Lynnley profile image

Jackie Lynnley 9 months ago from The Beautiful South

When I came here I did write about it, in fact is why I came here but I was very upset about things that happened to her everywhere she went (hospitals, nursing homes, rehab), it really was unbelievable, like a curse and so many many things, things I have never talked about. Then she lost use of her feet and legs because they were not exercising her as they claimed they were and I could no longer take care of her. It really was a slow torture they put her through and she was denied things as small as a chocolate pudding that she so loved. I try to think about the happy things now because there were about three years of her torture I fought every day even from a distance when I handed her over to family trusting them and giving them their chance to have her near them (as they claimed they wanted) and they dumped her in a home and never once went to see her again even passing by her probably once a day or more.

It isn't a pretty story. Raises a little rage in me yet if I think about it. They can none hurt her anymore and I know she and God knew I loved her so much and would have done anything I could have.

Well....guess you see why I don't write about it anymore. Hang onto your mom as long as you can. Once you lose control it can be an awful outcome.


lambservant profile image

lambservant 9 months ago from Pacific Northwest

Wonderful. My client and friend is repetitive with her questions and I seldom get weary of it except when she as things with a complicated answer, such as when we're watching TV she will ask " Do you know what they're talking about?" The answer is too difficult to understand. Also her dear husband died Last fall. It is painful to have to see her expression when she asks where he's at as if he was just in the bathroom and I have to tell her he's with Jesus. Fortunately she is able to express her feelings very well and by the time she's done so she has forgotten.

Bless you Dora.


DDE profile image

DDE 9 months ago from Dubrovnik, Croatia

Interesting and I learned a lot from you on this medical issue. MsDora you shared a helpful hub. I Tweeted!


rajan jolly profile image

rajan jolly 9 months ago from From Mumbai, presently in Jalandhar,INDIA.

Thanks for educating on the many aspects of this disease. It certainly is a plus point to read practical answers from you who has a lot of experience with this disease as you take care of your mom. Thank you.


manatita44 profile image

manatita44 9 months ago from london

Nice work! Great knowledge and understanding. I am thinking that hospitals could benefit from this. Pass them on to Human Resources. After all, you seem to be somewhat like Bill in the sense that you have found a useful series now.

I saw a woman in Grenada three years ago. A family member who was repeating herself quite a lot. She did not even know who I was. But I told her and she remembered my family and I. She was to ask me who I was a few more times in the conversation and upon returning to her on my way home.

I hear that there is an exciting pill on the market with a high success rate for people just before developing Alzheimers. Look it up. Much Love, Dee.


MsDora profile image

MsDora 9 months ago from The Caribbean Author

Jackie, thanks for sharing and I'm sorry about the pain. I used to wonder why people didn't give the details of the Alzheimer's stories until I discovered for myself how difficult it is to share the hurtful, embarrassing, humiliating parts. You are wise to let those those parts go; I do not mean to have you revive them.

You are doing very well to hang onto the pleasant memories of the good times you shared with your mother. It is obvious that you loved her very much and there is comfort in the fact that she is now free from suffering.

Some days I am so stressed, I am ready to give up my mother to a home, if I could afford it; then I think about the negatives from that situation when I'm not around. Your advise is helpful--to hang onto her as long as I can. The situation keeps me praying for strength, patience, wisdom and whatever it takes to be an effective caregiver to my mother.

Again, you are a great encouragement to me, and possibly others.


MsDora profile image

MsDora 9 months ago from The Caribbean Author

Lori, I can tell that you have a caregiver's heart. Thanks for sharing about your client who is blessed to also have you as a friend. God's blessings on you too--and on your friend!


MsDora profile image

MsDora 9 months ago from The Caribbean Author

Devika, thank you for your continual encouragement. Happy that you learn from these articles.


MsDora profile image

MsDora 9 months ago from The Caribbean Author

Rajan, writing about this seems to be an assignment for me. I pray that I do justice to these topics, and that people are helped. Thank you for your encouragement.


MsDora profile image

MsDora 9 months ago from The Caribbean Author

Manatita, thanks for your kind support, also for sharing about that pill. I will look into it. I seem to write better about human interaction than the process of the disease itself; but I try to learn all I can about it.


Sandi Kroeger profile image

Sandi Kroeger 9 months ago from Minnesota, USA

Thank you for sharing your information and your insight into Alzheimer's. Many years ago my grandmother suffered from Alzheimer's before she died. Although it wasn't diagnosed as that at the time (more than 30 years ago) I know that's what it was now after I've practiced as a nurse in a hospital for over 30 years. It's a devastating disease for everyone involved and any information or assistance you can provide to others will surely be appreciated. Many hugs to you!!


Jackie Lynnley profile image

Jackie Lynnley 9 months ago from The Beautiful South

I hope you do try for some free time Dora, we are only human and you have to have at least a few hours a week. Perhaps you could exchange favors with a friend to not cost you much, if anything.

I will pray you will get some free time so you are able to hang onto her.


MsDora profile image

MsDora 9 months ago from The Caribbean Author

Sandi, thank you for your encouragement. Nice meeting you, and hope to see you around on HubPages.


MsDora profile image

MsDora 9 months ago from The Caribbean Author

Jackie, I appreciate your concern, your hope and prayers. God bless you for your kindness and more!


grand old lady profile image

grand old lady 9 months ago from Philippines

This is so beautiful, Ms. Dora. My mom had Alzheimer's. She is long gone, but I think of her often.


MsDora profile image

MsDora 9 months ago from The Caribbean Author

Mona, hope you enjoy sweet memories of your mom. Thanks for your kind comment.


annart profile image

annart 9 months ago from SW England

Not only do you raise awareness in these articles, Dora, but you give such good advice and satisfactory ways of coping with difficult situations, difficult questions and the emotional stress that goes with them.

I know how it feels and I wish I'd been able to read your hub a few years ago; it would have made things easier for both me and my mother. I'm a fairly patient person but it wasn't easy and my distress often took over. Your 'excuse me' for a little time out is such a simple suggestions but we can overlook the simple when we're in a stressful situation.

Your advice is invaluable to those who have to cope now. Sharing.

Ann


MsDora profile image

MsDora 9 months ago from The Caribbean Author

Thanks, Ann, for reading and sharing. Researching and writing on these topics helps me cope and also makes me a better caregiver. You encourage me.


Happymommy2520 profile image

Happymommy2520 9 months ago from East Coast

Thank you! I am going through the same thing with my dad that has dementia. I new new to this and your TALK advice is helpful!


BlossomSB profile image

BlossomSB 9 months ago from Victoria, Australia

Dora, this is such interesting advice - and so helpful, too. Someone I was once close to had a mental illness and during that time she hardly ever asked any questions. If she did, it was a great sign that she was connecting with the world around her, so I was always so glad when it happened. Such a different perspective. You must have great patience!


MsDora profile image

MsDora 9 months ago from The Caribbean Author

Blossom, thank you for sharing. I also know that some Alzheimer's patients lose their communication skills and do not talk at all. I do have the opportunity to practice patience, so pray for me, please.


lifegate profile image

lifegate 9 months ago from Pleasant Gap, PA

Hi MsDora,

You know your topic and share it in a way that is practical and sensible. You've established yourself as an expert here on HP, as we look forward to learning more about the disease. Thank you!


MsDora profile image

MsDora 9 months ago from The Caribbean Author

Bill, I'm learning as I go, and sharing it helps me retain the information. People like you encourage me. Thank you.


AliciaC profile image

AliciaC 9 months ago from British Columbia, Canada

This is another excellent hub in your series, MsDora. You are helping people who read your hubs as well as your mother. Best wishes to you. I know that life must be difficult for you at the moment.


MsDora profile image

MsDora 9 months ago from The Caribbean Author

Alicia, trying to make the best of it. Just think, if I didn't write these articles, there would be so much encouragement that I would miss. Thanks for your kind support.


MsDora profile image

MsDora 9 months ago from The Caribbean Author

HappyMommy, thanks for your input; sorry I missed your comment earlier. So glad that you find the article helpful.


Frank Atanacio profile image

Frank Atanacio 9 months ago from Shelton

MsDora you really have the handle on this topic.. you are careful sharing your information.. and you are respectful on how you disseminate.. love your articles on this and other touching subjects bless you


MsDora profile image

MsDora 9 months ago from The Caribbean Author

Frank, such an encouraging comment. I'll keep on trying to deserve it. Thank you very much.


BlossomSB profile image

BlossomSB 9 months ago from Victoria, Australia

I do feel for you, as I have an idea of how difficult life must be for you, especially with someone you love. God bless and praying for you both.


swalia profile image

swalia 9 months ago

I have learnt so much on this topic through your hubs. Thanks for sharing!


Faith Reaper profile image

Faith Reaper 9 months ago from southern USA

Hi MsDora, I wish I had this article to refer to when my mother would ask the same questions over and over. These are wonderful and practical suggestions. You always cover a topic well. Blessings to you and your mother


MsDora profile image

MsDora 9 months ago from The Caribbean Author

Thanks, Blossom. I appreciate your prayers. God bless you, too.


MsDora profile image

MsDora 9 months ago from The Caribbean Author

Swalia, thanks for your encouraging comment. I myself am learning as I research and write.


MsDora profile image

MsDora 9 months ago from The Caribbean Author

Faith, thanks for your kind comment. I'm sure that you did the best you could for your mom. Blessings on you, too.


AudreyHowitt profile image

AudreyHowitt 9 months ago from California

Responding to the emotion--what a great thought--this was really a wonderful hub. So glad I read this this Sunday morning!


aviannovice profile image

aviannovice 9 months ago from Stillwater, OK

I never realized that this was so difficult. A friend's father recently died, and had dementia. She never complained, and was so stalwart. She must have had nerves of steel, but she always spoke so highly of her father.


MsDora profile image

MsDora 9 months ago from The Caribbean Author

Audrey, thanks for reading. Glad it added to your Sunday morning refreshing. Have a great week!


MsDora profile image

MsDora 9 months ago from The Caribbean Author

Deb, it can be difficult especially before you learn the ropes, but like your friend must have realized, complaining is not the way to go. Thank you for sharing.


vocalcoach profile image

vocalcoach 9 months ago from Nashville Tn.

You are a blessing to me Dora. My younger sister has Alzheimer's and is being cared for by her bachelor son. It's very hard on him. Heather calls me every evening and I can see that she is declining little-by-little which breaks my heart. She is suspicious of her own children and even gets mean with everyone except me.

I've learned to simply listen and not try to reason with her anymore. It's important that I support her and bring her some kind of peace and joy.

Your hub has brought me the answers I seek.

Thank you from the bottom of my broken heart.

Blessings to you.

Audrey


MsDora profile image

MsDora 9 months ago from The Caribbean Author

Audrey, your first sentence makes my day; we bless each other. Thanks for your encouragement. I feel for Heather, her son and all the rest of the family because there is no telling how long they will have to endure. So glad that you are there to support them.

As I opened up your comment, my mother called me away. She was standing at her bedroom door asking me to show her to her room. The confusion spreads, but it helps to bring the best out of us who are still sane. Best to you and all the family!


yecall profile image

yecall 8 months ago from California

Your hubs are just beautiful and I really love them. Yes, I do think the reason they ask over and over is more for reassurance than anything else. It must be so hard for you to hear the very same question over and over. That really takes its toll upon you but your hubs are educating everyone about this trying disease.


MsDora profile image

MsDora 8 months ago from The Caribbean Author

Yecall, thanks for your encouragement. I'm learning and sharing and being happy when others find the information useful.


bravewarrior profile image

bravewarrior 8 months ago from Central Florida

Dora, these articles very enlightening. Thank you for sharing your knowledge and experiences. They are important lessons we should all heed. We may never have to use them, but are well informed for if and when the time comes.


MsDora profile image

MsDora 8 months ago from The Caribbean Author

Shauna, I feel the same way. Having the information also helps us recognize the symptoms even before we hear the diagnosis. Thanks for the input.


Greensleeves Hubs profile image

Greensleeves Hubs 3 weeks ago from Essex, UK

Dora sorry I have not commented on this before. But now I have come across it may I say how important it is, and how useful the advice is? I have experienced some of this with my father. He is gone now but I remember a very distressing time.

Ill health is often difficult to cope with, but dementia is so much more traumatic for many. There isn't the hope of a cure to cling to, and because of the forgetfulness and confusion which are symptoms of the condition, one can feel that a loved one has been lost even while they are still alive. It can indeed be much harder on the family members than on the sufferer. The distress caused to the carer, coupled with the frustrations you have described, can lead to depression and an inability to cope. Many of the suggestions you give can and do work, but it is also important, as some others have suggested, to try to get a break, share the burden with others, and not carry it all on your own shoulders.

I hope everything is OK with you today, and you are coping. I will share.


MsDora profile image

MsDora 3 weeks ago from The Caribbean Author

Alun, thanks for sharing from your own experience. It was difficult but I am happy that I had the opportunity to be there for my mother. She passed four months ago, and I know that I am a better person having served in a caregiver's role. I appreciate your kind thoughts.


Greensleeves Hubs profile image

Greensleeves Hubs 2 weeks ago from Essex, UK

Sorry to hear about that Dora. The reward of a caregiver in these circumstances may come during the life of the person you are caring for - in smiles and hugs and thank yous - or it may come after they have passed, in the certain knowledge that you have helped make their final years as comfortable and calm as possible. Either way, the reward comes.


MsDora profile image

MsDora 2 weeks ago from The Caribbean Author

Alun, thank you for your kind comment. My mother passed four months ago and I am rewarded with the satisfaction that I gave my best to her care and comfort. I appreciate you!

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