Alzheimer’s Disease Challenges: When Every Day is Groundhog Day

by Nancy Wurtzel on January 29, 2013

This post was written by Nancy Wurtzel.  It was first published on the website MariaShriver.com.  Please take a minute to visit the Maria Shriver website and see all of the great information and writing for yourself.

When you are caring for someone with memory loss, the days all run together.  Indeed, it may often seem as though you are living in a remake of the movie Groundhog Day, where nothing ever changes.

Life is like a stuck record.

This is especially true when the person with dementia has severe short-term memory loss and asks the same questions repeatedly, an action called preservation – the uncontrollable repetition of a particular response.  In dementia patients, preservation is often fueled by confusion, anxiety and fear.

My mom, who was diagnosed with dementia five years ago, displays lots of repetitive behavior, but she doesn’t ask repetitive questions that can push a caregiver to the brink. On the other hand, my dad, who died 13 years ago from Alzheimer’s, was severely affected with short-term cognitive impairment.  He drove everyone to distraction by asking the same questions over, and over, and over.

These repetitive queries are truly exasperating.  As a caregiver, what can you do to alleviate the tension and stress of getting caught in this seeming endless Groundhog Day experience?

First, you must give up the idea of correcting the person or assigning blame.  “I just told you that,” or “Why do you keep asking me the same question?” will mean nothing to the affected person as he or she cannot control the behavior.  Lashing out will only end up making you feel worse.  Instead, concentrate on managing the behavior.

Managing dementia behaviors should always begin with a medical practitioner who understands Alzheimer’s and other dementia-related diseases. There may be anti-anxiety medications that could help the person significantly.

Back at home, there are techniques that may lessen the behavior and allow you to keep your cool.

For example, you might attempt to turn the situation around. “Hmm, I don’t remember what time dinner is served, Dad.  Do you know?

If you get an answer, then the question is probably being asked out of boredom, anxiety or habit.

Another idea is to give the person both a verbal and written response.

Keep a big stack of unlined index cards and a marker handy.  When the person repeatedly asks: “When are we going to the doctor?” You can look him or her directly in the eye, verbally answer, and then point to the index card where you have written, ‘Doctor 2 pm.’

You can also take a proactive stance, by sitting next to the person, asking the question and pointing to the card while verbalizing the answer.

What else can you do to keep your sanity if you are experiencing a Groundhog Day?

It may sound awful, but you can simply ignore the repetitive action.  This is a difficult route as the dementia-affected person can go on a long time before giving up on a line of questioning.  Personally, I don’t have the stamina.

Instead, I suggest other creative ways to cope.

Distracting your loved one from the behavior is probably one of the more effective techniques.  Take a walk or share a snack.  Any activity can be helpful as a short-term fix.  With my dad, we often brought out a family album and talked about the “old days,” which he could remember quite well.

Assigning tasks also can be a great diversion.

My mother recently moved into an assisted living home.  The staff recognized she was bored and needed something to occupy her time.  So, every morning, an aide brings Mom to their airy laundry room where she carefully and proudly folds towels — the same towels every single day.  The staff thanks and compliments her and Mom goes back to her apartment feeling appreciated.

Touch therapy is gaining new respect in all areas of caregiving.  Rubbing the person’s back or arms or even holding hands may be enough to break a cycle of questions.  If nothing else, making affectionate physical contact is a good move, and you’ll feel the stress level decrease in both of you.

One of my own tricks is to sing the answer. I used this technique quite effectively with my daughter when she was young.  She often had endless questions when we were traveling in the car.  Instead of brushing her off, I’d sing answers to her.  Singing a response allows you to engage in a fun manner, and perhaps you might even get the person to join in.

If singing isn’t your style, then try some appropriate music and crank the sound up a bit.  It’s a great distraction, and it is difficult to lose your cool when great music is playing.

You could also try substituting something else in place of the questions.  Does your loved one remember the words to the Pledge of Allegiance or a prayer?  I suffer from insomnia and often use the Pledge as a silent nighttime mantra so my thoughts won’t wander off to what I call ‘worry land.’

Sometimes, too much information can lead to an endless loop of repetitive questioning. For instance, if Cousin Mary is coming to visit, don’t tell your mother until right before she is due to arrive.  Otherwise, Mom may become totally fixated on this event and the questions will begin.

Also, save your caregiving energy by making your answers brief.

I learned this lesson the hard way when my father was in the early stages of dementia.  It was at the dawn of the internet age and every other commercial or television show loudly boasted a dot com address.  Whenever Dad heard this, he’d ask the same question: “What is that?”

At first, my sisters’ and I would launch into a detailed explanation of the internet while Dad listened intently.  Nodding his head, we believed he understood.

However, we quickly learned he couldn’t retain the answer, which lead to Dad asking the same question over and over: “What is dot com?” Our answers got shorter and shorter, which worked temporarily.  But eventually the dot com questioning became a nightmare.

Our solution was twofold.  We limited television time, and when we did watch TV we’d create a distraction or leave the room whenever a dot com was mentioned on air.

Yes, escaping to another room for a few minutes is, in fact, a good coping device.

It makes sense that if no one is within sight to question, the person may eventually lose his or her train of thought and the repetitive behavior could be averted.

I’ve mentioned this recurring incident about my dad to others — how we all quickly fled the room to avoid the inevitable question — and sometimes receive a judgmental look in return.  However, I know from first-hand experience it is better to retreat than lose your temper and berate the person who cannot help his or her behavior.

Caregiving has been the biggest challenge of my life — and sometimes the most rewarding.  My advice is this: If you have to be stuck in a dementia-induced Groundhog Day, then use your imagination to cope in the best way possible.  It will help you maintain your own mental wellbeing.

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