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Johns Hopkins Health Alert

What to Do About Question Repetition and Cursing

Dr. Peter V. Rabins and his team of psychiatrists and neurologists at Johns Hopkins answer questions about common behaviors of patients with dementia.

Dementia Behavior Question 1: My husband (82 years old) was diagnosed with Alzheimer’s eight months ago. He has now reached the stage where he asks the same question repeatedly, sometimes for several hours. I try to be patient and give him a real response to the same query, but it has gotten to the point where I can say just about anything and it really makes no difference what I say. Is there any "proper" way I should handle this behavior, or is there a medication that may reduce this type of behavior? He currently takes Aricept. Via email

Answer. Question repetition is a very common behavior with Alzheimer’s, and your struggles with it are similar to those of many other caregivers. Unfortunately, since this behavior results from the impaired memory that is an early hallmark of Alzheimer’s disease, the only medical therapy for it is the medication he is now taking.

Your attempt to answer him each time is both admirable and understandable, since we all would be insulted if our questions were not answered. However, after answering it once or twice, it is sometimes better for all involved to change the subject, to respond that you cannot answer right away but will in a minute (distraction), or to give a very brief response ("no” or "yes”) when a longer one would be more informative. It sometimes helps to get the person engaged in activities that keep him or her busy -- adult day programs are one way to do this -- since he is less likely to ask questions if he is otherwise engaged.

Dementia Behavior Question 2: My 86-year-old mother-in-law has lived with my husband and me ever since she was diagnosed with frontal-lobe dementia eight months ago. In the past, I have taken her with me to go grocery shopping, but lately she has been having outbursts that appear without provocation. She will start to curse a blue streak like an angry dockworker and I can’t get her to stop. I now leave her home, which upsets me, but I don’t have any choice. Is there any way she might lose this profanity aspect of her dementia, or is there a good medication you could recommend for her? Derby, CT

Answer. Emotional outbursts of the kind that you describe can occur in frontotemporal dementia (FTD) and any other disease that causes a brain injury. Sometimes their provocations are quite minor, but sometimes no obvious causes can be found. If this behavior happens only when you take her to the store, it may well be that being in the grocery store -- with its bright lights, bustle, and noise -- is the stimulus. If that is the case, try to find other places you can go together that don’t elicit the behavior. Keep in mind that this behavior does not in any way reflect what a person was like before the disease.

Posted in Memory on November 19, 2007
Reviewed July 2009

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The views expressed here do not constitute medical advice, and do not represent the position of Johns Hopkins Medicine or MediZine LLC, which has no responsibility for any comments posted on this site.




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