Today I want to look at #6 on this chart “Never say ‘I told you,’ instead Repeat/Regroup.” (Take a look at my blog for 3.24.17 to get more details regarding #1 arguing.)
So what does that quote mean to a caregiver who is soooo frustrated because (she) has answered the same question for the billionth time in the last hour? How does a caregiver maintain her patience and understanding when day after day and hour after hour the same questions are asked over and over and over again?
Let’s look at two things that are happening to the the care-receiver to help us understand why those same questions keep popping up.
First – to use an example. You have a file drawer that is filled with manila folders that represent your Mom’s personal history and cherished memories. The files at the front of the drawer are the most recent experiences and as you go further back in the drawer you move back through history – through time to your Mom’s childhood. Memory loss from Alzheimer’s disease or any other form of dementia attacks those memory files in the drawer. So as your Mom’s memory disappears, it is like a nasty secretary or “memory steal-er” removes the files in the front of the drawer – and throws them away or shreds them. Those are her memories from yesterday, or last week, 3 months ago or the past year. Once the “memory steal-er” removes those files, there is nothing for your Mom to draw from to recall experiences she has had. So as time marches forward the “memory steal-er” will take files that represent the past 5 – 10 years and eventually the past 30-45 years, etc. Meanwhile the drawer in the filing cabinet is being emptied out of memories with absolutely no way to stop the process or recover those files. There’s no back-up plan, or server or thumb drive to rely on to recover those memories. Eventually all of those memory files are gone. Your Mom has no control over what is occurring and doesn’t even realize what is happening to her… because she can’t remember.
Second – let’s look at what is happening to the brain. Alzheimer’s disease and other dementias that impact memory loss start in a certain part of the brain called the hypo-campus. There are two of these – close to the center or core of the brain – one on each side. This is where new or short-term memories are created before those memories move to other parts of the brain where they are stored. As Alzheimer’s or one of the dementias begin to impact the hypo-campus, it begins to shrink and is no longer able to function properly. If you have a new computer but it hasn’t been set up yet by your IT person, then there is no way to store files or photos in it….. similar idea. You have it, but it just isn’t functioning.
Now that you have more of an understanding of what is taking place, you will understand why saying to your Mom “I just told you that 5 minutes ago!” or “Why do you keep asking me the same question?” doesn’t work for your Mom. She has no way to comprehend what was said or done 10 minutes ago or this morning or last night. Her brain is no longer capable of handling new information because her brain is not working properly. Her brain is sick.
We don’t expect someone who has a broken arm in a sling to continue carrying on life as she did before the arm was broken. Neither can we expect your Mom with Alzheimer’s or dementia to carry on life as she did before she became sick.
When those repetitive questions come, you have to pretend you have just heard them for the first time. We constantly answer the same questions from young children without the same level of frustration and anger. But it’s different with adults. Try to remember that the brain illness that your Mom or loved one has prevents them from remembering so many things that otherwise would have been important in their lives. Their constant questions aren’t meant to intentionally upset you… they just have no mechanism in their brain to remember that they just said.
“Repeat and Regroup” is for another installment. Stay tuned and please let me know if this has helped you in any way. I hope to hear from you.