Culture of Caring Series: Repetitiveness

So many people who live here do things that are repetitive

like pacing and asking the same questions over and over again,

or repetitive movements like hand slapping,

and I'm not sure what to do.

Sometimes it's annoying to me, and sometimes it's

annoying to other people that live here.

Should I just try and ignore them or make them stop?

[TAPPING NOISE]

Mr. Jones,

you've been doing that for 30 minutes.

I told you to stop.

It's very annoying.

I'm just gonna take you to your room now.

No,

stop.

We're going.

You're not coming out of your room until you stop tapping.

Stop pushing against me.

Come on.

[TAPPING NOISE]

OK. Here you are.

Repetitiveness can be exhibited in a variety of ways.

A person could do the same movement over and over,

say the same word or phrase again and again,

or ask the same question repeatedly.

When you're assessing a person who's experiencing repetitiveness,

the first thing you should do is make sure the person is not in harm's way,

or that the repetitiveness is not going to cause harm to another person.

If the repetitiveness is not causing harm to the person or someone around them,

you may decide

just to ignore it,

but ignoring the repetitiveness does not mean ignoring the person.

The repetitiveness could be a way to express a physical need.

The person could be hungry.

Hi,

Mr. Jones,

I brought you a snack.

Are you hungry?

I don't know.

Here.

Or thirsty…

[TAPPING]

Hi, Mr.

Jones.

I saw you were

tapping your arm

there.

Are you

thirsty?

No,

I don't know.

I brought you some water, here.

There you go.

They could have a need to stretch or walk around.

OK.

They could be uncomfortable.

The person could be too hot

or too cold.

They could need to be repositioned or have assistants repositioning themselves.

The person could need to use the restroom.

[BACKGROUND MUSIC] [TAPPING]

Hi, Mr.

Jones,

that music's kind of loud.

I'll turn that down for you.

You've been in this room for a while.

You need to use the restroom?

I don't know.

You don't know?

Let's go take a walk to the restroom.

Here,

I'll help you up.

Mhm,

there you go.

You could take my arm.

Right.

Here we go.

Repetitiveness

could be the result of the person being bored

or having a need to engage with others.

Once you've assessed the situation and determined

that the person is not in harm's way

and that their physical needs are met,

try engaging them in some other activities.

You might consider helping the person move to another room or another part

of the home, where they can interact and visit with other folks.

Activities

should be meaningful.

You can help them get a project started with

the activities coordinator or engagement specialist at the home.

Perhaps they could help prepare the silverware for mealtime.

Hey,

Mr.

Jones,

thanks so much for doing the silverware.

We really appreciate it.

Other activities could include working in the yard,

planting flowers,

weeding,

painting the picnic tables.

Maybe the person that you're working with would like to

write a letter to a family member or friend.

Here we go.

We got you situated with a drink,

a snack.

You're writing a letter to your grandson?

I heard it's his birthday next week.

A walk in the fresh air

is always good for the person that you're assisting

and for you.

Isn't it nice to be outside?

Initiation is a term which describes

moving from one activity

to another activity.

For example,

maybe watching television and initiate a new activity

by getting up and going to their room to read a book.

The process of initiation is a mental process.

Diseases such as Alzheimer's disease and other related dementias,

traumatic brain injury, or autism

can cause problems with initiation.

This is where you come in.

You could help the person initiate a new activity with some

of the suggestions and recommendations we offer in this film.

Tips to help with repetitiveness:

One: Assess Safety.

What is the person doing?

Is it safe?

If they continue doing their repetitive action,

are they going to hurt themselves or someone else?

If so,

calmly stop them as soon as you can.

Get help if needed,

but try to stop the unsafe action in the least aggravating way possible.

Two:

Assess Human Needs.

Repetitiveness that is not causing harm may not need to be interrupted,

but could be a sign of a human need that the person cannot express verbally.

If there is an unmet need or want,

for example,

hunger,

thirst,

boredom,

or pain,

meet that person's needs.

Maybe they just need to use the restroom.

Physical needs might include

thirst,

hunger,

the person may be uncomfortable

they may be too hot,

too cold,

or need to be repositioned.

The person might have psychological or social needs, such as, one—boredom.

In this case,

help the individual find something meaningful to do to them,

such as walking outside,

helping prepare the silverware,

writing a letter,

or creating a work of art.

Two—loneliness.

Help the person find ways to talk and do something with other people,

such as play a game,

do a craft,

or hang out with someone who works there,

such as a nurse or a CNA.

Three—

overstimulation.

Create a peaceful environment in which the person can regroup,

such as near an aviary or looking out a window,

their room or another quiet area.

Adjust the environment by reducing noise,

adjusting lighting,

or turning on peaceful or their favorite music.