Why Someone With Dementia Keeps Asking the Same Question

0:00Careblazer, if your loved one has repeated the same question five times in the last hour, When are we leaving? Who's coming over? What's for dinner? You are definitely not alone. Hairblazers inside of our support groups, the hairblazers I have consultations with, they tell me things like my mom literally asked me what's for dinner 47 times yesterday. 47 times. I'm ashamed of myself. I literally counted. I know I'm supposed to be patient. I know that they can't help it. But after the same question for the 20th time, I snapped. I couldn't help myself. Or he's asked me the same question 12 times in five minutes.

0:42Does he really not remember? Sometimes I think he is doing this on purpose. So sometimes what this looks like is literally them asking the same exact question over and over. Sometimes it's not actually a question at all. It might be a story that they tell you over and over. The same story you've heard many times. Sometimes these questions and stories can happen a lot in a very short window of time, and sometimes it's just something that they say and bring up day after day. Careblazer, real quick, if you learn better by watching things, then you can hop on over to my YouTube channel where I post these podcasts in video format, sometimes have different visuals to help people learn even better.

1:28You can just type in Careblazers into YouTube and I will pop up. All right, let's get back to today's podcast. Now we know that dementia damages the brain, but it doesn't damage the brain in the same way all the time. It doesn't damage everything all at once. And so there are a few things that are happening neurologically to explain why this common experience of them repeating the same story or the same question is happening. So let me walk you through some of those key things. Number one, the brain's recording system, the hippocampus, it is damaged. The hippocampus is this small region in the brain that acts like a recording device.

2:10So when something happens, a conversation, a meal, something that they experienced, the hippocampus captures it, consolidates it so that it can recall it later. But in Alzheimer's disease and other types of dementia, the hippocampus is often one of the first areas of the brain that experiences damage. So this recording device becomes damaged. Even though you are answering your loved one's questions, your answers are never getting stored. So technically, it's not that they are forgetting what you told them. It's that they never even captured what you told them. They never even had the chance to forget because they couldn't even encode it in the first place.

2:55Think about it in this way. You're trying to fill a bucket with water, but that bucket has a bunch of holes. No matter how much water you keep pouring in, the water is going to keep running out. The bucket never has the ability to fill up. So in this way, you can think about the disease damaging the bucket. Things are not getting stored. Number two, the emotional system, our brain's emotional ability to feel and process information, that stays intact and working longer than other areas of the brain. Basically, the emotional memory stays much longer. So this is really important, and I think it can help us think in a different way about these repeated questions and repeated stories.

3:38So the hippocampus, we've just learned, it stores factual information. Who was there? What happened, what was said. But there's a different area of the brain that stores more emotional memory. Basically, it stores how things feel. This is the amygdala. And the amygdala is much more resilient to the damage of dementia, especially in the early and middle stages. So what this means is that your loved one will remember how they felt much more than what you said. Basically, your loved one will remember how your response made them feel more than what you actually said in your response. So if your answer to them conveyed a sense of warmth and compassion, that answer might stay with them.

4:29That feeling of the answer, that feeling of reassurance might stay with them longer than you just providing a factual response without some of that warmth and compassion. It's like they're able to settle down despite not having this specific memory. If, like all caregivers do, no judgment, if you responded at times with impatience or frustration, even though they can't remember maybe exactly what you said, they are left with feeling unsettled. They are left with feeling like something is not quite right, and that might be driving more of the questions and stories. Basically, the feeling outlasts the facts.

5:09Number three, sometimes this repetition is a form of anxiety. When somebody is repeating themselves over and over, it might not be information seeking. It might be anxiety relief seeking. What are we doing today? What are we doing today? What are we doing today? Over and over and over. Might not necessarily be because they really want to know what they're doing today. It might be, am I safe? Do I belong here? I'm not quite sure where I am or what I'm doing or what I'm supposed to be doing. Am I in the right place? Am I doing the right things? It might be a form of anxiety, but because of the dementia, they might not have the awareness themselves that they are actually anxious instead of just wanting information.

5:52They might not have the ability to express to you, I'm feeling nervous or anxious. I'm not quite sure what I'm supposed to be doing or saying. And so it shows up as information seeking and repeated questions when really they are just looking for some comfort, some reassurance, some relief that they are okay. That's why often providing the information doesn't seem to work or help them settle down because it's not information they're after. They're after something that's going to help relieve their anxiety. So before I get into what are some specific things that you can do to help in these situations, not only to help your loved one, but to help you, let's talk about some of the very common responses caregivers tend to have to this symptom and why they don't work.

6:37We all have the best of intentions, but sometimes our habit brain, our desire to just get over this frustration already, our desire to not be struggling has us react in ways that sometimes, oftentimes, are not helpful when it comes to dementia. So number one, we don't want to remind them. They just ask the question. You just asked me that two minutes ago. That doesn't help because that statement is requiring them to remember that previous experience of two minutes ago, which we just learned the hippocampus never even stored it. It's like it didn't even happen. So that kind of response tends to maybe make them more confused.

7:19It can even cause them to feel shame or embarrassment or sadness that something happened that they can't remember. Number two, giving long, factual, detailed answers often also does not help because anxiety is not looking for more information. Anxiety is looking for reassurance, comfort, and relief. Sometimes providing too much information can increase anxiety because it's just more words and information that they are not processing, that they are not able to hold onto and remember. Number three, I know this one is so hard and we're still going to do it from time to time, but just remember our visible frustration and impatience is likely going to increase their confusion, frustration, and anxiety because when they are struggling to understand what they're saying, they are absolutely understanding how we are feeling and they take that on.

8:13And when they can't understand exactly what you are trying to express, what they do understand is that you are not okay. You are frustrated about something. You are impatient about something. And so then they start to take on those feelings as well because they're not able to fully understand the full picture. And the last maybe common mistake I'll mention here is just trying to redirect them from the question too quickly. So they're asking you for the 50th time, when is Sue coming over? When is Sue coming over? When is Sue coming over? And you want to distract them, redirect them to something else without acknowledging that they just asked a question.

8:53So that can increase their confusion and anxiety because it feels like we're just totally ignoring them. And I get it. Sometimes we literally are. But to use active listening skills, look at them, show them that you heard them can be helpful and even repeat back their question or just simply give them the answer. Honestly, the simplest thing, I'm about to give you all the things that you can do. The most simple thing you could do with the situation is just provide them with the information as short and simple, as concise as possible. And sometimes that will buy you a couple of more minutes. That will buy you a couple of more hours.

9:28But there are some other tips here. So let's dive into those. Number one, respond to the feeling, not just the question. So for instance, if they are asking over and over, when is dinner? When is dinner? When is dinner? instead of just providing the information of dinner is at six o 'clock you can also address the feeling underneath that they might be having uncertainty anxiety just kind of fear of the unknown so you could say dinner is at six o 'clock don't worry I've got everything taken care of I'll come get you when it's time and that's just enough in that moment to set them at ease so not only are you answering the question you're helping address the anxiety underneath the question number two We've kind of already mentioned this, but keep your responses short, warm, and consistent.

10:14The fact that they are asking the same question over and over again is not a clue that you need to change your answer or come up with a new way to say something. That's not going to help. The reason they're asking the same question again is because they never encoded it and they cannot recall what you said the first time. So make it easier on yourself and just use the same response each time. Dinner is at six o 'clock. Dinner is at six o 'clock. Don't worry, I've got you taken care of. Dinner is at six o 'clock. Don't worry, I've got you taken care of. I'll come get you when it's time. We don't need to come up with, oh, well, dinner is soon in 45 minutes or dinner will be ready when I come get.

10:54We don't need to find different answers because we think that since they forgot, the answer we used didn't work. We can just use the same answer. Short, consistent, warm. That's what we're going for. Number three, use visual cues and written reminders for factual questions that they repeat often. Again, sticking with the dinner example, if they are frequently asking what time is dinner, you can put something in front of them, a piece of paper, a sign, a whiteboard where you use a marker, and it will just say dinner is at six. And so they have that in their field of view. That might be enough for them to not ask the question so much.

11:34Also, if they are asking the question, you can point them, oh, what's that sign say right there? Oh, I think it's right there written. Oh, look right here. And so we're starting to encourage them, train their brain to start looking at the sign for that factual information. Number four, this one does not get talked about often in dementia care because it is a proactive approach. And much of the approaches that are talked about are reactive, meaning here's the approach to use after the behavior has already happened. My favorite kind of approaches are here is a strategy you can use before the behavior happens in the hopes of reducing that behavior from happening altogether, maybe preventing it from happening altogether.

12:15This strategy is all about increasing reassurance and connection before the behavior tends to happen. So if you notice that your loved one tends to repeat themselves around a certain time of day, around a certain activity of the day. So for example, a certain time of day, let's say starting around 3 p.m., they start asking about dinner. When's dinner? When's dinner? And so you know between the hours of three and six, they are always going to be asking about dinner. What you might want to do before that three o 'clock hour rolls around is look for moments of connection. Look for moments where you can reassure them.

12:53You can sit with them. You can hold their hand. You can watch a show together. You can give them some attention. You can provide them the information you know they are about to ask. Hey honey, I'm making lasagna for dinner. Dinner's at six. I'll be sure to come get you. We can just give it to them proactively. Sometimes that kind of takes a bit of our frustration away. And also, maybe it's not a specific time of day when it happens, but maybe there's a certain trigger. So let's say the trigger is you. Every time they see you walk into the room, you're the trigger for them to ask the question. So when you come into the room, now what you can do is just provide them the information up front.

13:32Oh, I'm so excited for dinner tonight. I'm making lasagna. Dinner's at six. I'll come get you. And then you move on. And there's something, even though we're still using the same words, there's something about doing it proactively that makes us feel like we are more in control that reduces a little bit of that frustration and impatience of having to answer the same question over and over again. And also just as importantly, it's providing some comfort and reassurance to our loved one with dementia. And tip number five, probably the most important one. I've said it a ton of times and I will continue to say it a ton of times.

14:05Give yourself permission to not be perfect. Nobody is perfect. You're still going to get frustrated. You're still going to get impatient. You still might snap from time to time. None of that means you're a horrible caregiver. If anything, it means you're an extremely committed caregiver doing so many things, juggling so many things, probably exhausted and tired and worn out. And we are human. We are not robots. We are going to do things and say things that maybe are less than ideal. And that is okay. It is no reason to beat yourself up. Now, I know it is so extremely easy for me to be here on a screen and say, hey, if somebody repeats themselves over and over, the easy thing to do is just to answer them.

14:46I get it. I mean, literally, it is that simple. However, it is not that easy because the internal experience of caregiving, the decisions day after day, moment after moment, all of the things that you have to do, it's hard. It kind of chips away at your feeling of peace, at your just feeling like you can get through the day. It's this huge weight that keeps building and building and building. So I get it. Even if the answer is simple, it's not easy, especially when you consider everything else you're doing in caregiving. You're not just answering questions all day. You're doing everything else that comes with it, not to mention managing and getting through your own life and maybe other family members that you are helping as well.

15:33So hopefully this video gives you some more understanding about why the brain is repeating like it does. Some ideas of things to try to lean in on more to help if this situation is happening to you. And Careblazer, if you would like to be surrounded with other caregivers who get it, who know exactly what it's like to be in an exhausting situation where it feels like there is no end in sight, I strongly encourage you to check out our care collective program where we come together week after week, multiple times a week with other care blazers, with myself, with other experts, and we share and we provide support and we provide information so that you don't have to go through this alone.

16:14Everything is recorded. You can access it 24 seven. There's ways to participate and get your specific questions and challenges addressed. Even if you never show up live, we've been doing this for a while. We understand the busy caregiver schedule. So we've worked the program around your life. Strongly encourage you to check it out. If you are just wishing that this process and journey was a bit more easier, dare I say even a little bit more enjoyable, it's possible. You can learn more if you go to www.careblazers.com and you can click on the four families section. Also, my book is coming out, the Dementia Care Toolkit, and there is information on the website for you to sign up for our priority list.

16:58We will be the first to know about all the good news happening in the book, as well as a lot of free goodies we have coming out just to celebrate that this is happening. Careblazer, I'm sending you so much love. As always, I will be back next week with a new video. Sending you love. Bye.