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

@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