How To Best Handle Those Common Repetitive Behaviors | TLA0040

Are you caring for a loved one with dementia? You don't have to figure this out all on your own. Welcome to Truth, Lies Alzheimer's, the show that helps you reimagine a new relationship with your loved one, a relationship a little more free of stress and anxiety. Join host Lisa Skinner and her 30+ years of experience as she guides you on a new path to a better relationship with those you care for. Here's Lisa.

Hi everybody, welcome back to another new episode of The Truth, Lies Alzheimer's Show. I'm your host, Lisa Skinner, and I am once again very honored to continue our exploration of the multifaceted world of Alzheimer's disease. This is where we delve into the complex and often misunderstood world of Alzheimer's disease and related dementia. I'm here for you to navigate through the truths, the myths, and challenges surrounding this condition. So join me now as we explore the latest research, share personal stories, and provide valuable insights into what living with Alzheimer's disease and related dementia is truly like for people who have it. Whether you're a caregiver, a healthcare professional, or someone impacted by Alzheimer's disease, this show is dedicated to shedding the light on these truths dispelling the lies, and offering hope in the face of this challenging disease. So on today's show, I am going to explain to everybody one of the most frustrating behaviors that we commonly see with dementia. If you haven't guessed what it is, it's repetitive behaviors. I know that it is such a common source of contention with so many family members and so many caregivers. I hear it every single day. And I've been there and done that too. My mother-in-law, uh, displayed repetitive behaviors. Hers weren't too bad. She liked to tuck and fold a napkin and stick it in her purse, and then she would take it out and then Fold, tuck, repeat, fold, tuck, repeat. That was her repetitive behavior. But some of our loved ones will ask the same question over and over and over again in the same conversation, as we know. And then others will tell the same story over and over and over again in the same conversation. And we want to go stick our heads in the gas oven. So I am going to give you some insights on how to better manage that situation because it happens every single day to a lot of our loved ones or people that we're caring for, and it is really a source of frustration for all of us. And I'm gonna kind of delve into why repetitive behaviors occur, and then some tips on how to manage it so it won't drive you as crazy. Okay, so here we go. Repetitive questioning definitely is a common behavior in people with Alzheimer's disease, and it can be attributed to several factors related to the cognitive and neurological changes that occur in the brain. And as I said before, many, many, many of us feel very frustrated. It's one of the biggest sources of frustration of this disease that we all experience, um, as a recipient. Am I right? Okay. So one of the things that occurs and why, uh, and triggers repetitive behaviors is the impairment on their memory. Alzheimer's disease often leads to significant memory loss, as we know. It's a hallmark of Alzheimer's disease, particularly in the short-term memory. As a result, individuals with Alzheimer's disease may forget that they've already asked you the question and possibly received the answer that you gave them. Leading them to repeat the same question or the same story multiple times within a short span of time. And I know a lot of us, and I'm guilty of it too, "Mom, you just asked me that. I already answered that question." Okay, so the first thing to be mindful of, they don't remember that they asked it 27 times before. So there is a way to kind of change the direction or the course of that behavior, and I'll go into that in a little bit. So maybe they're having communication difficulties. Alzheimer's disease impairs a person's ability to process and retain information as well as express themselves effectively. The individual may ask the same question repetitively as a way of seeking reassurance or trying to make sense of their surroundings, emotions, or experiences. So in other words, some of the repetitive behaviors that we experience are triggered because they're feeling scared and they're feeling insecure, and this helps calm them. So Keep that in mind. Now, anxiety and disorientation, which we know are common symptomologies of Alzheimer's disease and dementia, that can trigger repetitive behaviors. People with Alzheimer's disease may experience heightened anxiety. We all know that. Or confusion. We all know that. Especially in unfamiliar or overstimulating environments. Repetitive questioning can be a way for them to seek comfort, gain a sense of control that they feel that they are— have lost or are losing, or ground themselves in the present moment. Loss of inhibition, which happens with Alzheimer's disease, it can result in the loss of inhibitory control leading to repetitive behaviors such as asking the same question repeatedly without the individual being fully aware of their actions. I hear from a lot of family members that it's not just repeating the same question, but telling the same story over and over, which does very commonly happen. It's important now for caregivers and loved ones to approach repetitive questioning with patience, and empathy. Redirecting the individual's attention, providing clear and reassuring responses, and creating a calm and structured environment can help manage this behavior. Additionally, maintaining consistent routines, using reminders, and engaging them in activities that promote mental stimulation and comfort can contribute to reducing this repetitive questioning. Understanding the underlying reasons for repetitive questioning in Alzheimer's disease can also aid in providing compassionate care and support for individuals living with the disease while also helping caregivers and family members navigate these challenging behaviors with empathy and patience. So it's not just being patient or compassionate or responding with empathy, but understanding the triggers behind these repetitive behaviors, which I just went over with you. In addition to understanding the reasons behind repetitive questioning in individuals with Alzheimer's disease, caregivers can employ various strategies, and I'm going to discuss that with you next. To effectively manage this behavior and provide compassionate support. Here are some additional approaches that caregivers can consider when this behavior happens. So first and foremost, maintain a calm and reassuring attitude. If you're stressed, they'll be even more stressed. They pick up on your emotions. They pick up on your body language, your facial expressions, et cetera. Responding to repetitive questions with patience, reassurance, and calm— and a calm demeanor can help reduce the individual's anxiety and provide them with a sense of security. I mentioned that a little earlier on. So the other approach is establish a routine. And a routine that becomes familiar to them every single day. Creating and maintaining a consistent daily routine will help individuals with Alzheimer's feel more oriented and secure, potentially reducing the frequency of repetitive questioning. They function best in surroundings and environments of familiarity. So the next thing is distraction and redirection. So if the repetitive behavior has started, you're not maybe not quite sure what triggered it, but it was one of the things that I mentioned, gently redirect the individual's attention to a different activity. Because one of the things we know, people who live with Alzheimer's disease and dementia, they get locked onto and locked into a thought, and they will hold on to that thought, that question, that story, until they feel that they've been listened to or that it's okay for them to move on. Sometimes we have to help them move on. They're not going to do it on their own, so they keep asking the same question. Or tell you the same story or fold the same napkin and take it into, uh, tuck it into their purse until we fix the broken record. And that's basically what it, what it's, uh, synonymous with. So engage them in familiar, enjoyable activities, or you can provide sensory stimulation that that definitely can be an effective strategy for redirection. Provide clear and simple responses. So what does that mean? When responding to repetitive questions, it's going to be beneficial to you to offer clear and simple answers. Don't get too much into the weeds or detail or elaborate. Just clear and simple answers. You can use visual aids such as calendars, notes, memory aids, and these will also help reinforce the information you are communicating to them. This is really important. Validate their feelings and emotions. What does that mean? Okay, acknowledging and validating the individual's feelings and emotions, even if they are expressing the same concerns repeatedly. Offer comfort and understanding can definitely help alleviate distress and confusion. And I'm gonna give you some examples of some things that you can say to them in just a very short while. So the other thing that you need to be aware of is their physical comfort level, and you need to always be monitoring that. Ensure that the person you're caring for or your loved one, that their basic needs are met. Very, very important. That means, are they hungry? Are they thirsty? Are they uncomfortable? Is there too much noise or confusion in their environment? Um, are the lights shining on them too brightly? These are all things that can trigger repetitive behaviors. Discomfort and/or unmet needs can and will contribute to increased agitation and repetitive behaviors. So caring for individuals, and I don't need to emphasize this, you probably already know, Caring for individuals with Alzheimer's disease can be so overwhelming and challenging for any of us, for all of us. And it's important for us as caregivers to seek support from other family members, friends, and/or support groups. Taking regular breaks and finding time for self-care is vital. For maintaining emotional well-being. And even if that means just walking out of the room that the person you care for, your loved one, is in, taking a deep breath, recharging or re-energizing yourself is better than staying in that situation and just becoming more and more frustrated. You can also communicate with healthcare professionals if, uh, That is an optional resource for you. But the point is, is this is very, very difficult to do if you are alone or if you feel alone. It definitely takes a village to manage this disease. So don't sell yourself short on that. So continuing on, managing repetitive behaviors in individuals with Alzheimer's disease. Again, it requires so much patience from us and all the patience that any one of us can muster up, even if we have to dig, dig, dig down to find one last little ounce of patience. And that's not an easy feat. I know. Uh, you have to be creative in your approaches. You have to try different things. And that's the toolbox that I help you assemble. So if one thing doesn't work, you can try something else. And we always want to be mindful that this is a person-centered approach to care and to communication, that it's about what works for them, not us or somebody else living with the disease, because everybody goes through this disease differently. Here are some very specific strategies 4 caregivers or family members that you can use to manage repetitive behaviors effectively. So again, engage them in a meaningful activity. Encourage the individual to participate in an activity that they enjoy and find meaningful. This could include listening to familiar music together, maybe singing some of the lyrics together. Looking through old photographs. That's a great one. Engaging in gentle exercises and/or participating in simple hobbies. Meaningful activities can help redirect the individual's focus and reduce repetitive behaviors. Set them on a different track, as I said. Create a calm environment. This is huge. And a lot of people don't realize that these are triggers of these type of behaviors and agitation and anxiety. It's, um, noise in a noisy environment, distractions, clutter in the environment. To create a peaceful and organized space, or at least their perception of that, you can play soft background music. Pleasant aromas in their environment and offer them familiar objects that can contribute to a calming atmosphere. Provide simple choices, once again utilizing memory aids such as labeled drawers or cabinets to help the individual locate essential items independently. They're losing their independence day by day by day, and that is a very scary thing for most. So help them stay as independent as they possibly can without loading them up with too difficult of tasks because that's frustrating for them too. So ways you could accomplish this is by providing visual cues such as signs indicating the location of a bathroom. Or the dining area, and could also assist in reducing confusion and repetitive questioning. The next thing you can try is offering transitional objects. So that means you're providing the individual with a comforting item such as a favorite blanket, a stuffed animal, a memento, These items can offer a sense of security and may help reduce repetitive behaviors during moments of distress or anxiety. It's comforting to them. It's a security product for them. And then techniques such as gentle massage. We already discussed aromatherapy or redirecting their attention to something else. When the individual engages in repetitive behaviors, gently redirect their attention to a different activity or topic. For example, if the individual is repeatedly asking about a specific event, transition the conversation to a different pleasant memory or topic of interest. Mom, tell me about this. Dad, Tell me that story again when you were young and you were in World War II, and see if he comes up with a story. Communicate with empathy. That means approaching the individual and understanding where they're coming from, that this is difficult for them to communicate and they're trying the best they can. And a lot of times, because they can't articulate their thoughts, their expressions, their wants, their needs. They're going to express them the only way that they know how to, to resort to, and that is in these behaviors that show up with this disease. By implementing these strategies and remaining tuned into the individual's unique preferences, again, the custom approach to care, person-centered approach to care, and responses, you as family members and caregivers can help mitigate these repetitive behaviors and create a supportive environment for individuals living with Alzheimer's disease and related dementia. In addition to these strategies mentioned earlier, caregivers can consider the following approaches to effectively manage repetitive behaviors in individuals with Alzheimer's disease. You can provide purposeful engagement. In other words, encourage the individual to engage in a purposeful activity that aligns with their abilities and interests. So you, you need to be aware of their skill levels and then offer them something that they can feel that is accomplishing for them. If it's too difficult, they will get frustrated and that'll increase their anxiety. But this could involve very simple tasks such as allowing them to fold the laundry, setting the table, watering some plants, which can provide a tremendous sense of accomplishment and reduce their restlessness and their Anxiety. People need to feel that they have retained a purpose in their life. Even people living with Alzheimer's disease and dementia, it never goes away. It's a very, very basic human instinct in every single one of us. So it could be something so simple but so meaningful to them. So don't project what you think is meaningful into what they might believe is meaningful because they're worlds apart based on their cognitive decline. Use reminiscence therapy. I've gone over this before in previous episodes, but just as a reminder, reminiscence therapy involves discussing their past experiences, sharing stories with them, and looking at old photos and mementos. This can be so valuable to help them engage in meaningful conversations and redirecting their focus away from the dreaded repetitive behaviors. Offer them snacks and hydration. Very important for the elderly. Ensuring that the individual has access to healthy snacks And the other thing you wanna do is remember that acknowledging their feelings can foster a sense of security to reduce their anxiety, which may help decrease repetitive behaviors. Monitor their medications and health. If this could be a, a reaction to a prescription medication, again, maintain clear communication. Encourage physical activity. You might wanna have them do some chair exercises, stretching exercises. That's good for everybody to do every single day. Create a comforting bedtime routine for them. Maybe end the day with some hand massage so it relaxes them. And then foster social communications with their peers, their friends. Do family member FaceTimes. Things like that. Don't forget, you need to practice self-care. You will not survive this without that, or having a backup plan for somebody that can give you a respite, a rest, a little bit of time off. By implementing these diverse strategies and remaining attentive to the individual's unique needs and responses, we as caregivers and family members will create a supportive and enriching environment for individuals living with Alzheimer's disease, ultimately contributing to their overall well-being. We know this is a fact. So before I end today's episode, I want to share with you some of the ways that you can validate their feelings. This is very important because they're feeling scared, they're feeling insecure. One, acknowledge their emotions. You can say something to the effect of, well, it sounds to me like you're feeling upset about not being able to visit your childhood home. I understand how important those memories are to you. And you probably— that triggered a thought.

Yeah.

My mom's always asking for me to take her home, but that's in her reality. So that's a good way to kind of, um, validate her feelings of insecurity. Reflecting their feelings: I can see that you're feeling anxious about the upcoming doctor's appointment, but you know what, it's totally okay to feel that way, and I am here to support you. Validating an experience. It seems like you're recalling a happy moment from your past. I'd love to hear more about that special memory if you would like to share that with me now. Affirming reality-based emotions. I see that you're feeling worried about finding your way around. Well, that's perfectly natural to feel that way in a new place. We've all been there, done that. And I'm here to help you navigate that, so don't worry. Expressing understanding. I understand that you're feeling frustrated because you can't remember where you put your glasses. It's okay. Come on, we'll look for them together and I'm gonna help you find them. And then the last one, respecting an individual's perceptions. So you as a family member or caregiver could respond with something along these lines: You believe that your old friend is coming to visit today because that's what they keep telling you. That sounds wonderful. I'm glad you're looking forward to spending time with them. I am too. So these are specific examples of how Validation techniques involve empathetic listening, acknowledging the individual's emotions and experiences, and responding with understanding and compassion. Can make a world of difference to them and to you because you're gonna feel less anxious and stressed out too. By employing validation, caregivers can create a supportive and comforting environment Fostering trust and emotional well-being for those individuals living with Alzheimer's disease and related dementia. So that's our episode for today. Thank you all again for being here. I love bringing you helpful information of how your lives can be a little easier to manage if you are caring for somebody with Alzheimer's disease have a loved one who's living with Alzheimer's disease or related dementia. I will be back next week, and I hope you have a wonderful week. Thanks again for being here. Bye-bye.

Thank you for listening to Truth, Lies Alzheimer's. We hope you found something in today's episode that helps. We understand that caring for a loved one with dementia can be the challenge of a lifetime, but you don't have to do it alone. If you're ready for exclusive access to even more great content and resources, head on over to Facebook and join Lisa Skinner's Minding Dementia support group. We're a community of like-minded caregivers, and we're here to help.