Repetition is "expressing concern, ask for help or coping"

dancsfo

An Alz.org page states

https://www.alz.org/help-support/caregiving/stages-behaviors/repetition

"People with dementia who ask questions repeatedly may be trying to express a specific concern, ask for help, or cope with frustration, anxiety or insecurity"

Does that apply to your PWD? I'm not sure what "help" one is asking for, unless it is a question about something specific, like a CD account maturing or when a pension payment is deposited. Then I can answer it. Most of the time, it's an observation like "it is quiet these days" (PWD is hard of hearing but does not acknowledge). Or "how's so and so doing" (the person has long ago died). I just answer with a fib to avoid sadness.

PWD often mentions a grandmother who lived to 100, went to take a nap, and died in her sleep. This is repeated daily, many times, so I've probably heard it thousands of times. I just acknowledge it and try to change the topic. Perhaps there is a desire to die peacefully, but there's little else I can say? I guess it's a form of coping.

I don't want to engage the PWD in a conversation on this topic of death, and it can lead to sadness, anger or agitation. All I say is that it's a nice way to "go", and leave it at that, until I hear the same thing again.

M1

I think that statement is a futile attempt by a nondemented person to assign a causative reason for a behavior that is irrational. Sorry to be a cynic but i don't think it means anything.

one rare morning last week my partner was out of bed when i got to MC and we went to sit outside for a few minutes. Another resident who is generally calm and gentle sat down next to us. In two minutes she asked us about ten times if we had a room inside. The interesting thing was that it completely exasperated my partner, so we got up and left. It's so fascinating to me that she recognizes this behavior in others as frustrating even though she does it herself.

harshedbuzz

@dancsfo

I believe the assertion to some degree.

PWD lose language; even when the mechanics of speech remain intact, many will loss vocabulary, prosody, syntax and the ability to code switch (which may be related to loss of social filter).

But I still think speech can still be used to connect in the ways your quote mentions even with significant loss in the ability to use language conventionally. Combined with reading non-verbal behavior, you are probably doing a better job of figuring out what your LO needs from you in the moment as their person than you're giving yourself credit for.

My dad remained vocal and verbal until his death from aspiration pneumonia. His use of language was typically more about a generalized anxiety and social connection than requiring something specific.

In the middle stages, dad developed a kind of reverse-shadow behavior. Since his custom was to plant himself on the sofa (the apathy and inertia were real), he would call out to my mother. This drove her crazy as she was trying to, in her words, get things done. But it was more than that, she was angry with him and with dementia— she lost her carefree snowbird lifestyle, became responsible for every task associated with keeping the household afloat, and she'd lost her handsome and engaging partner. To some degree her anger at him was justified in that one of his dementias was an ARD and self-inflicted to a degree. Given that emotional intelligence remains intact well until the end stages, he was accurately interpreting her lack of attention as the avoidance it was. This ramped up his anxiety which fed the need for reassurance through asking questions or calling for her. When we discussed this at our IRL support group meeting, the leader made the same suggestion I had (she tended to ignore me)— proactively checking in with him regularly with a kind gesture. This helped a lot, as did tweaking his medication.

Dad told a lot of stories like you describe on repeat. In retrospect this wasn't a surprise as he was by nature a very social creature and quite the Irish storyteller in any gathering. We saw this behavior, mid and early-late stage, most when he was in a group setting like the doctor's office or a small holiday gathering. He had certain scripted monologues on repeat that were word-for-word. We didn't see this behavior much at home and many of the stories were highly conflated with him as the hero-protagonist. And usually quite cringe as the youngs say.

Specific to his story about his grandmother, could it be a segue rather than something you shut down? Dad used to talk about my late sister a lot. She'd been his favorite— a wild child, mini-me who also came to a tragic end. He was often hazy about whether she was dead, very ill or if he'd just had a bad dream. When he asked after her, he would typically end the question "she's dead, isn't she?" This was hard until I reframed his ask as a need to talk about something precious he seemed to be losing. Using it as a cue, I would retell a story about her from a happier time which he always enjoyed.

HB

Quilting brings calm

I guess it would depend on the ‘conversation’ topic. I put the word in quotes because there’s not really a conversation when it’s just answering the same question or statement repeatedly.

If mom repeatedly tells me that she’s ‘confused today’, it could be an expression of concern. Or not. She will also tell me repeatedly that she ‘played bingo in the activity room today’. That’s because she a) can’t remember what she said two minutes ago and b) has not much else to talk about. Those two reasons are valid for the ‘confused today’ repetition too.

housefinch

Or……it’s a sign of brain damage. Period. End.

HollyBerry

I definitely notice the endless loop/repeat feature comes when there is anxiety. We get in the car to see the horses and she asks 10 times in 15 miles if we remembered the carrots. Yesterday she interrupted me while I was WFH every two or three minutes to talk about cancelling a volunteer opportunity. On the way to a Dr appt, she asks over and over where we're going and why.

dancsfo

I tend to agree that there's not much causation between those needs and repetition, so it may be wishful thinking. But as others have implied, if there's nothing to lose by using a repeated story as a segue to a conversation, then maybe there's no harm in trying.

I tend to shut things down when I repetition, since I am afraid that engaging PWD in some way that upsets them can result in uncontrolled crying or explosive anger. But I think I've learned how to manage that (or maybe PWD has changed), so I don't have to worry about walking on eggshells as much as before. I bet shutting things down must feel mean to a PWD (at least those in early to mid stages)

Fuzzysocks123

https://alzconnected.org/discussion/comment/218306#Comment_218306

it’s interesting you say that. I’ve noticed this too with my MIL. She’s in the mild stages so she attends a senior center near our home. She complains about a particular woman at the center that according to her repeats the same stories over and over but she herself does the same thing.