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My mother has dementia. She has started to use the phrase, "Help me" all the time. We ask her questions to see if we can figure out what she wants or needs; however, we really don't get that much of a response back from her. Within minutes she is again saying, "Help me." Why does she say this all the time? Can you provide some information on this behavior? Thank you!

It is not uncommon for an Alzheimer's disease patient to repeatedly ask the same question or repeat the same phrase over and over. The repetition is a function of the disease; your mother is not purposely trying to annoy you. Alzheimer's disease impairs a patient's short-term memory, so a patient effectively forgets that the same question or request has already been asked and answered. Just remember that your mother's forgetfulness is just as confusing and frustrating to her as it is to you.

In some cases, a patient may be physically bothered by something but cannot properly communicate what is wrong. Try first to rule out all the obvious culprits: she may be too hot or too cold, she may have a wound or sore or be sitting on something uncomfortable, she may have an ache or pain that is not outwardly noticeable (a toothache, joint ache, urinary tract infection, etc.), she may have to use the toilet or have indigestion, or she may simply be hungry, thirsty or bored. Talk to her primary care physician about this. If she has not had a physical in a while, you may want to consider scheduling an exam so that physical ailments can be ruled out.

In most cases, however, repetitive requests usually stem from a particular fear or anxiety. For example, if the patient repeatedly asks you when a doctor's appointment is scheduled, it may be because she is anxious about going to see the doctor. So when you talk to her, try to address the underlying emotion in the question ("I'll be right there with you the whole time at the doctor's office.") Since your mother repeatedly requests that you help her, it may be because she feels insecure or scared, that she cannot understand what is going on and is afraid of what is happening to her. She may literally feel helpless in a sense, and does not know how else to express herself.

In this case, all you can do is reassure her that you are helping her and then try to shift her attention to a new subject or activity. When possible, try having her “help” you with some activity (naming long lost relatives in old photo albums, folding clothes, mixing dough, sorting items into piles, etc.) This can provide her with a sense of self-worth and may even reduce some of her anxiety. Because of the nature of Alzheimer's disease, your mother will require continual calm reassurance that everything is fine, that you love her, and that you will continue to care for her.

Anything you can do to help reduce your mother’s anxiety and uncertainty may also help to reduce the repetitive requests. For example, you can use notes, signs, or even a written daily schedule on a wall chart to help remind her when it is time for meals, bathing, activities, bedtime, and so on. And if you are trying to get her to do something and she becomes agitated, be patient and explain what you want her to do with simple, straightforward instructions.

Posted 18 Nov 2009

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