Perseveration is the persistent repetition of a word, phrase or gesture despite discontinuing the original stimulus that led to the word, phrase or gesture. It is a very common symptom of Alzheimer’s disease, most often beginning in the early stage, and the symptoms increase significantly as the disease progresses.
For example, if you ask an affected person where he was born and he answers “Baton Rouge,” he may then answer "Baton Rouge" again even if the question is “What is your favorite color?” “Baton Rouge” will be the answer to a variety of questions. He is virtually stuck on this particular response and is unable to switch ideas. The affected person is unaware of his repetition; it is involuntary.
Perseveration occurs in Alzheimer’s disease and also in frontotemporal dementia other dementias and other brain disorders such as schizophrenia or traumatic brain injury.
A type of perseveration called graphic perseveration also has been observed in people with Alzheimer’s disease, Lewy body dementia and vascular dementia. Graphic perseveration is when a person continues to draw the same shape or figure he was originally asked to draw. For instance, an affected person may be asked to draw a box and does so. Asked to draw a circle, he continues to draw the box each time.
Caregivers and health care professionals, naturally, become very irritated and impatient of this constant repetition. There are tips and strategies to help the affected person get off this proverbial "hamster’s wheel.”
Always look for a reason behind the perseveration behavior. Does the behavior occur around certain people, in a particular environment or at a certain time of day? The person may be trying to communicate in these circumstances, so the caregiver should take a deep breath and try not to be reactive but think about how the loved one is feeling at the time.
Reassurance, redirecting to an enjoyable and meaningful activity, going for a walk or some other form of exercise, listening to music and staying calm and patient are all ways the caregiver can assist in making the affected individual comfortable and less fearful.
Avoid challenging what the affected person is saying or pointing out that he is repeating; that will only cause more anxiety and agitation.
Questions about Alzheimer's disease or related disorders can be sent to Dana Territo, the Memory Whisperer, owner of Dana Territo Consulting, LLC, at firstname.lastname@example.org.