How Do I Cope with Constant Repetitive Questions?

"My elderly mother keeps repeating the same things and asking the same questions over and again. I'm getting quite stressed and worry about getting angry with her. What can I do?" Eldercare specialist and life coach, Dr. Lesley Trenner provides her expert advice on this personal dilemma

Dear Lesley

I care for my elderly mother and in recent months she has begun to repeat the same things, and ask the same questions, repeatedly. It has got worse over the last few weeks and the other day, for example, she asked me the same thing sixteen times within a matter of a few minutes.

I'm not a qualified carer and lack the patience that a full-time carer would need, and am starting to feel quite stressed by it all. Is there a technique I can use, to help me keep calm and not get angry and upset, and also something I can do to help steer my mother away from her repetitive course of conversation?

I really sympathise with you. My mother used to ring me dozens of times during the day with the same question and unless you've experienced this it's hard to understand just how frustrating it can be.

Much as we may know that repetitive questioning is a symptom of dementia and that we "ought" to be patient, we still get stressed out. If we try and answer the same question over and over again, the stress levels shoot up. If we snap or ignore it, we feel guilty. It can get to the point where it feels like the person is "doing it on purpose" to be annoying, even though we know logically that it's part of their illness.

I think the first step towards coping is to realise that there is no "solution". No matter what we do, the person with dementia will repeat themselves. But although we can't stop repetitive questioning, we can try to understand why it happens and find different ways to react. This can reduce the amount it happens or at least lower the tension so it's possible to concentrate on other things.

Why the constant questions?

Why do people with dementia ask the same question over and over again, sometimes within minutes?

• Memory loss - The simplest explanation is that they have forgotten that they asked the question. Or they may have forgotten the answer. Plus, if they have hearing loss, they might not have heard the answer properly.
• Anxiety - Sometimes, what sounds like a request for information is actually about an underlying worry. For example "What day is it?" could mean "My son always visits on a Sunday and I think I've forgotten to make lunch".
• Confusion - "Is John back yet" might mean "Who will look after me now my late husband isn't here?"
• Boredom - It may be that the person with dementia has been on their own or sitting doing nothing for a long time. They then seek attention, in the way a child does who wants something to do.
• Stress - If the environment is crowded, noisy, busy, the question "When are we going home" might mean "This is too much for me".

How to respond

Figuring out what the question means can be a guide to knowing how to handle it. With that in mind, here are some suggested ways to deal with repetitive questions. It's hard though because dementia affects everyone differently and it can take a while to work out what's best for any one person in a given situation, especially as the disease progresses.

If at all possible, keep calm. Avoid shouting, getting cross or saying "I've just told you that". It would take a saint not to do this sometimes but it increases the stress for the person being asked and the person asking the question, making it more likely that they will keep asking. Pre-empt the question or the worry behind it. For example, if you know there is anxiety about someone who isn't there, you can keep saying "I am here, I am looking after you today."

• Change the subject - just switch topics. Talk about something that happened during the day. Or point out the window and talk about what's outside.
• Ignoring the question can work occasionally. Or you could try physical contact instead - maybe a hug or holding hands and just saying "It's OK".
• Take the person away from stressful, noisy or unfamiliar environments.
• If the questions are about day, time, place, try simple visual aids - perhaps a large calendar on the wall or prominent clock that shows the day, date and time.
• Try sticking notes onto objects explaining how things work, reminders of things to do, visitors who are coming that day.
• A simple family tree or photo album with clear explanations can provide reassurance and orientation.
• Find the person asking the question something easy but useful to do. For example, if you are helping your mother by cleaning or tidying her home, or cooking a meal, you could ask her for some help in some way.

Sometimes, it may be best just to answer the same question over and over again. In that case:

• Speak slowly, loudly and clearly. Talk directly to the person.
• Answer very simply - just one idea per answer. There's no need to tell "the whole truth and nothing but the truth".
• Try to avoid answers involving logic or reasoning - they may not be able to understand this.

Avoiding stress and guilt

One of the hardest things about repetitive questioning is how bad it can make the listener feel, especially if you are trying to do other things at the same time. Or it may feel rude or disrespectful not to keep answering.

I think the most important thing here is to recognise that this is not a "normal" conversation and some of the ways in which you communicate with your mother no longer apply. You shouldn't worry about being overly accurate or honest. If you are talking to your parent, it can be hard to take on board the idea that you are now "parenting" them.

• It may help you to slightly distance yourself from the questions, disengage her emotions and just keep saying some stock phrases that reassure, whilst having your mind on something else.
• You can diffuse the situation by using humour or singing a song.
• If she feels particularly stressed, she should leave the room for a while or go for a walk.
• It's important to get some "respite" from being a carer and not be afraid to tell someone trusted about how she's feeling.
• It's good to learn relaxation techniques like meditation, yoga or just deep breathing.

I do hope this helps.

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Dr Lesley Trenner is one of the My Family Care Speak to an Expert advisors and offers support for people with eldercare challenges, particularly balancing work and care