11. Focus on repetitive behaviour

People with dementia may repeat a sound, a word, a question or may repeat the same actions. They may also become very physically dependent and ‘clingy’ and follow the person caring for them.

The person with dementia may be disorientated or confused and the behaviour may be a way to comfort or soothe them. Sometimes they may engage in a repetitive activity with purpose such as packing and unpacking or continuously rearranging furniture. Often these repetitive behaviours are related to a former activity or occupation.

Other possible causes include:

  • Short term memory loss from the dementia causes the person not to remember that they have asked the question.
  • Depression, anxiety or pain.
  • Some medication can cause side effects which result in repetitive movements or restlessness. Anti-psychotic medication can cause repetitive movements of mouth and tongue.
  • Separation from a loved one or care giver may lead to concerns and questioning where they are.
  • Anxiety from misrepresentation of sounds and sights or overwhelming stimuli (movement or noise etc).
  • Boredom.
  • Getting stuck on one activity and not able to move to next step due to frontal lobe damage of the brain.
  • Inability to express needs such as hunger, thirst or needing to go to the toilet.

Repetitive behaviourWhat might help?
When someone is repeating a question over and over try to respond to the underlying emotion rather than the content of the question. ‘What am I doing today’ may mean the person is feeling lost and uncertain and a response to this feeling might help reassure them. ‘Where is my wife’ may suggest a need to be secure or need for intimacy. ‘Where are my children’ may suggest a need to be loved or needed. ‘When can I go home’ may suggest a need to feel safe.

Try to use a calm voice when responding to repeated questions and do not remind the person they have asked the question. Instead divert them to another activity.

Try writing answers to questions on a reminder pad to help the person remember.

Keep routines consistent and try not to discuss plans with the person ahead of time which may increase anxiety and repeated questions. Leave it until just before event.

Look for patterns in the behaviour (note the time of day, event or people who trigger the behaviour). Once the pattern is identified then it is easier to remove any triggers.

Sometimes certain things in the environment may trigger repeated questions. For example a coat and hat in a visible place may make the person ask repeatedly to go outside.

Repetitive movements may be reduced by giving the person something to do with their hands eg pairing socks, folding clothes, tearing up paper, sanding or dusting.
When a person becomes stuck on one task, touch or pointing may help cue the person onto the next step. Or use other positive distraction approaches such as music or pictures.

Check with the doctor to be sure that medications are not the cause of repetitive behaviours.

Provide stimulation and meaningful activities to alleviate boredom.

Ensure physical needs are met. Explore any need to go to the toilet, any pain, hunger or thirst etc.

Task: Think of a person you have known with dementia who has shown some form of repetitive behaviour. In your workbook describe the behaviour/s and then list what might have been possible causes.
In your notebook write down a variety of different approaches that might have helped.

Further learning

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