​Behavioural changes in persons living with dementia can occur as a result of changes in their brain.

The Department of Psychological Medicine from Changi General Hospital (CGH), a member of the SingHealth group, explains the common symptoms displayed by persons with dementia and offers caregivers tips on how to better manage these behaviour changes when caring for their loved ones with dementia.

Repetition (repetitive behaviour) in persons with dementia

Repetitive behaviour is a set of behaviours characterised by repetition, sleep problems, agitation, aggression and sometimes screaming and shouting.

Persons with dementia may often repeat a word, statement or question, or perform an activity repeatedly. This includes the tendency to ‘shadow’ their caregivers even when their caregivers go to the bathroom.

While these repetitive behaviours are usually harmless for persons with dementia, it can annoy and increase stress on caregivers.

7 Tips to manage repetition (repetitive behaviour) in persons with dementia

1. For persons with dementia, keep them occupied

Distract and engage your loved one with simple hands-on activities such as sorting laundry or vegetables, or provide a ‘rummage box’ with objects familiar to them, like an old button, old pictures, pieces of jewellery, watch, wallet, etc.

2. Assure your loved one that you still care

Acknowledge their feelings and reassure your loved one with dementia that he/she is safe and loved.

3. Ask your loved one if he/she is uncomfortable

Find out if the person you are caring for has unmet needs or discomfort such as thirst, hunger, feeling tired, toilet needs, etc.

4. Avoid letting the person with dementia get restless

Schedule exercises or activities to expend their energy, but not to the point of exhaustion.

5. Keep your home noise and clutter-free

Examine your home environment and try to reduce or eliminate noise levels, visual clutter or anything that could possibly trigger the behaviour in your loved one with dementia.

6. Discourage shouting, encourage talking

If your loved with dementia shouts for someone from their past, encourage him/her to talk about the person.

7. Keep a night light on to reassure

If your loved one with dementia starts shouting at night, keep a night light on in the room to help reassure him/her.

Remember: If the behaviour is not causing any harm to you or your loved one, you can choose to ignore it. However, do not ignore the person with dementia.

Possible reasons for repetition (repetitive behaviour) in persons with dementia 

1. The person with dementia is probably unware and has no recollection of having already said or done something.

2. The feeling of boredom, anxiety, stress or pain may cause restlessness, pacing and agitation.

3. The inability to express other needs such as hunger, thirst, feeling tired or having to go to the bathroom.

4. A need to be meaningfully occupied and to feel that there is a purpose and structure to their lives (e.g., a housewife who may feel restless in the early evening because she used to cook dinner at that hour – although she may not remember what she needs to do, the feeling of restlessness may cause agitation).

About BPSD (Behavioural and psychological symptoms of dementia)

Behavioural and psychological symptoms of dementia (BPSD) are neuropsychiatric symptoms and behaviours displayed by persons with dementia.

These symptoms constitute a huge aspect of dementia irrespective of its subtype, and they demonstrate a strong correlation with the degree of functional and cognitive impairment.

Learn how to manage anger and aggressionclick here.

Learn how to manage apathyclick here.

Learn how to manage inappropriate (disinhibited) behavioursclick here.

Learn how to manage hallucinations, click here.

Learn how to manage paranoia and delusionclick here.

Learn how to manage sundown syndrome, click here.

Learn how to manage wandering behaviour, click here.

Ref: H24