This time of lockdown with COVID-19 can be stressful for a person with dementia. Heightened anxiety can increase repetitive questioning. They may have understood your first answer, but due to changes in their brain, they are unable to recall asking the question or what was said to them.
Reminding them that you’ve already answered that question will likely be stressful for the person, and create confusion, a sense of inadequacy, or anger.
Try to respond calmly, with a reassuring tone – otherwise the person will pick up your frustration and may become more anxious and more repetitive. Keep your answers short and simple.
Try using more than one sense when answering a question, it may connect with a different part of the brain and aid their memory:
- Write on a whiteboard / sheet of paper / sticky notes – place these where the person can see them
- Draw a picture
- Demonstrate
- Put an object in their hands
- Walk with them and show them
- Look for the feelings and needs that are being expressed (by the question or their body language)
- Are they uncomfortable or in pain?
- Are they trying to communicate something to you?
- Are they bored, or lonely, and needing something to do?
- Do certain questions happen at a particular time of day?
- Maybe it’s when they used to leave for work, or children used to come home from school – be ready with a distracting activity when that time-of-day approaches
- Are they feeling anxious, sad, scared or unsettled about something?
Environmental triggers could be prompting the question:
- Are they reading/hearing upsetting information about COVID-19 from the media? Consider limiting access to TV/radio news at this time. Their routines may have changed due to COVID-19 and people they are used to seeing may be absent from their lives
- They may need some type of verbal or physical reassurance
- Are they trying to find something?
- Declutter and leave an object they repeatedly ask for in plain sight.
- Put a picture of the object on the cupboard door.
- Are they seeing something in their surroundings that prompts them to ask the question? e.g., if a photo triggers a repeated question, remove the photo.
Change the subject or distract:
- Begin talking about a different topic
- Point to something outside the window and talk about it
- Ask them about something from their past
- Ask them to help you do a simple task (folding the washing, wiping the table, something they enjoy doing)
- Offer a snack or drink
- Start singing their favourite song
- Take them outside to check the mailbox
- Sweep the floor or the yard with them
- Give them a stack of old papers to sort
- Give them some yarn or string to wind into a ball
- Begin doing some exercises with them
- Play a game
- Phone or have a video call with a friend or relative they can talk to
- e.g., Viber video/ Skype video/ What’s App video/ Facebook Messenger
What about those difficult questions?
Questions such as
- “Where is my Mum?”
- “Where is Pat (a son or daughter)?”
- “When will Bobby (deceased spouse) be home?”
- “When are you going to take me home?”
These questions reveal that the person with dementia is perhaps living in their minds at an earlier time in their life and in a different place.
Trying to reason and explain that this is now their home, or that the children are grown up and have their own homes, may not be comprehensible to the person if in their internal reality they are 37 years old and still living in the family home.
If they are told that their parent or spouse died years ago, the news may trigger a grief response every time.
It can be kinder to give the person an answer that will be acceptable for their “reality”, something you know would be plausible for the person they are asking about, and then change the subject or distract onto an activity.
- “It’s getting late, how about we go home after tea / in the morning”
- “Your mum’s out shopping”
- “Pats at the library/ hockey practice”
- “Bobby’s taken the car to the garage”
You may need to experiment with different answers until you find one that soothes and satisfies.
This way of answering may not sit well with those of us who have been committed to always telling the truth. But if the person you are caring for has lost the recent past due brain changes, could an answer that provides reassurance and comfort be more compassionate?
Finally, Be Kind to Yourself.
You are human. You may become stressed and frustrated with the person you are caring for apologise to them, laugh at yourself, give them a hug, and move on.
Feel free to contact us at Dementia Waikato if you need to talk about any issues you are having with the person you are caring for. We are all working from home and can talk with you on the phone 07 929 4042or via email info@dementiawaikato.org.nz