2.4. Identify possible reasons for repetitious questions and behaviour

This guide will help you answer 2.4. Identify possible reasons for repetitious questions and behaviour.

People living with dementia often ask the same questions repeatedly or display repeated behaviour. These actions can impact both the person and those around them. Understanding the reasons helps you respond with more empathy and skill. This guide covers why someone with dementia may act in this way.

The Nature of Dementia

Dementia is a collection of symptoms that affect memory, thinking, and ability to carry out everyday tasks. Common types include Alzheimer’s disease, vascular dementia, Lewy body dementia, and frontotemporal dementia. Each type can disrupt how the brain stores and retrieves information. As a result, a person can forget what has just happened, lose track of conversations, or become confused about their surroundings.

Because dementia affects the brain in this way, it can lead people to repeat themselves in both words and actions. Sometimes the reason is physical, sometimes emotional, and sometimes a mix of both.

Memory Loss and Forgetfulness

Loss of short-term memory is a key feature of many types of dementia. This means the person may not recall what has just been said or done, even a few moments earlier.

For example:

• A person may ask what day it is, not remember the answer, and ask again seconds later.
• Someone might forget that they have already eaten and ask for a meal shortly after finishing one.

If you see a pattern of repeated questions or behaviour, consider whether the cause is linked to memory loss. In these cases, the person is not being difficult on purpose. They are struggling to remember basic facts or events, so they ask again or repeat their actions.

Disorientation and Confusion

People with dementia often become confused or disoriented. This can be about time, place, or people. This disorientation triggers questions or behaviours that repeat.

Examples include:

• Asking where a loved one is, even if that person is in another room or has already been identified.
• Saying, “When are we going home?” while already at home.

Confusion can be distressing. To make sense of their world, a person may revert to routines or seek reassurance through repeated questions. This behaviour is their way of trying to find comfort or a sense of certainty in an uncertain world.

Anxiety and Insecurity

Dementia often makes people feel anxious or insecure. They know something does not feel right, but may not be able to say why. Repetition is a way to get comfort, reassurance or clarity.

Typical signs:

• Repeatedly asking about daily routines, such as “When is lunch?” or “Are you coming back?”
• Performing actions like packing and unpacking a bag.

These behaviours are a way of seeking safety and reducing anxiety. If routines or familiar faces change, anxiety can grow, making repetition more likely.

Lack of Stimulation or Boredom

A lack of activity or mental stimulation can lead to repetitious behaviour. People with dementia often have fewer activities they can safely carry out. If they feel bored, repeating actions or questions can fill the gap.

Common behaviours include:

• Pacing up and down the same route.
• Repeating the same phrase or question.
• Fiddling with objects or clothing.

This repetition becomes a default activity in the absence of other options.

Unmet Physical Needs

Repetitive behaviour may be the person’s attempt to communicate an unmet need. People with dementia can find it hard to say what is wrong. If they are hungry, thirsty, in pain, or need the toilet, they might act out instead of saying so in words.

Look out for:

• Standing up and sitting down repeatedly.
• Walking towards the bathroom or door.
• Repeatedly asking for help, but unable to say what the help is for.

Meeting these needs can reduce the frequency of repetition.

Frustration and Communication Difficulties

Losing the ability to express thoughts clearly can cause distress and frustration. When words are hard to find, repeating a question or phrase may be easier than trying something new. Sometimes the person will latch onto one phrase or action if it is the only way to signal that they need help or do not understand what is happening.

Signs include:

• Repeating the name of a family member.
• Re-stating the same feelings, such as “I’m tired,” due to lack of vocabulary or confidence.
• Echoing the last word or phrase spoken by someone else (called echolalia).

This is not deliberate. It is the person’s way of trying to interact with the world around them, even when communication skills are failing.

Responses to Environmental Triggers

Certain triggers in the environment can set off repetitious behaviour. These could be noises, changes in lighting, a new face, or a move to a different room. Sometimes these changes remind the person of past routines, such as work or family life.

Examples are:

• Hearing the school bell outside and packing a bag repeatedly, thinking it is time for work.
• Seeing staff with coats on and asking again and again, “Are we going out now?”

Managing the environment can sometimes help to lessen these behaviours.

Loss of Sense of Time

Time often becomes very confusing for someone with dementia. Seconds feel like minutes; minutes feel much longer. Because of this, asking “What time is it?” many times in a short space of time is an attempt to get a sense of control.

This can look like:

• Asking about the time shortly after being told.
• Becoming agitated if the clock seems to show a ‘wrong’ time.

Routine and gentle reminders sometimes bring comfort, but confusion about time is hard to remove completely.

Restlessness and Wandering

Some people with dementia develop strong urges to walk about or repeat specific actions, such as opening and closing doors or cupboards. This habit can be linked to boredom, anxiety, physical discomfort, or a build-up of unused energy. Sometimes the pattern is a leftover from past habits:

• Pacing as if late for an appointment.
• Checking exits because of an old habit related to a previous job.

Not everyone with dementia will experience wandering, but those who do may repeat the same action over and over.

Effects of Tiredness or Ill Health

Being tired, hungry, or unwell can make repetitious behaviours worse. Lack of sleep can affect thinking and mood. Illness, pain, or side effects from medication can all act as triggers.

In these cases you may notice:

• More questions in the evening, known as sundowning.
• Frequent movements or repetitive phrases when the person appears poorly.

Meeting the underlying need can sometimes reduce repetition, but not always.

Habitual Behaviour and Procedural Memory

Some types of memory last longer during dementia. Procedural memory (knowing how to do things, such as how to brush teeth or tie shoes) can remain even as other memories fade. Because these habits are strong, people might repeat actions that have become automatic.

For example:

• Repeatedly washing hands.
• Folding and refolding clothes.

This is not always a source of distress, but can be confusing for others to witness.

Emotional Distress or Depression

People with dementia are more likely to be affected by depression and emotional distress. If left unchecked, this can lead to repetitive actions or questions as a form of self-soothing. Asking the same question, moaning, sighing, or fiddling can be coping mechanisms.

Look for:

• Repetitive questions about a lost loved one.
• Regular comments about feeling lonely or sad.

Supporting emotional wellbeing may help.

Seeking Companionship

Dementia can feel very isolating, even among family or friends. People may repeat questions or actions as a way to get attention and make contact.

Watch for:

• Asking, “Are you there?” or “Will you stay with me?” over and over.
• Touching, holding, or following staff.

These actions show a real need for connection.

Examples of Repetitious Questions and Behaviours

It helps to link causes with concrete examples. Here are a few:

• Memory Loss: A person keeps asking the name of the care worker, forgetting it seconds later.
• Anxiety: They ask whether family are visiting, despite assurances that they will come later.
• Confusion: Someone living in a care home insists they need to collect their children from school, calling this out every afternoon.
• Boredom: Repeatedly folding napkins or stacking magazines.
• Unmet Needs: Pacing up and down because they need the toilet.

Supporting Someone Living With Repetition

When working with people with dementia who display repetitive behaviour, remember these tips:

• Stay calm, kind, and patient.
• Accept that repetition is not deliberate, nor is it within the person’s control.
• Listen for clues about physical or emotional needs.
• Speak simply and use reassurance when responding.
• Where possible, meet needs such as hunger, thirst, or pain.
• Provide safe and meaningful activities to reduce boredom or anxiety.
• Check that their environment is comfortable and free from triggers.
• Keep routines predictable, if possible.
• Ask colleagues or family about patterns or what works well for that person.
• Use distraction or redirection techniques kindly if repetition becomes distressing.

Everyone is different. Some may benefit from reminders or visual prompts; others may feel soothed by a favourite object or routine. In some cases, repetition is a harmless coping tool. Only step in or report if the behaviour puts the person or others at risk.

Final Thoughts

Repetitious questions and behaviour are common for people with dementia. As a health and social care worker, your insight and skill will help you approach each situation thoughtfully. Look beyond the surface. Try to spot the reasons for repetition, whether linked to memory, emotion, health, or environment. By adapting your care and staying patient, you will help the person feel safer and more respected. This understanding supports quality care and gives you the tools to work more effectively in your role.