In my geriatric practice one of the complaints of families is how often their loved one tells them the same thing over and over.
They use that symptom as evidence of cognitive decline – the inability to recall what was said previously. This symptom, although common and often indicative of cognitive functional decline, is also a manifestation of the common human propensity to focus on the narrative of one’s life and to recount it as part of one’s process of self-identity and validation. But, what is the separation between the normal attribute of recounting the narrative of one’s life and the pathology of cognitive impairment that fails to recognize the recent repetition of that story to a loved one?
The importance of stories
The telling of stories is important. In normal relationships and conversations, we spend much effort recounting life events to others. The tendency to be repetitive is universal, as anyone in a long-standing relationship will admit. If the topics of conversation between spouses are tracked over time, we would probably find the same topics repeated in one form or another repeatedly.
For instance, one partner in a marriage usually knows the political views of the other. When the topic comes up in a social setting, they often patiently listen to their partner express their views to presumably a new audience (although this is not always the case) with rare rude interruptions such as: “We’ve heard your views before. If you don’t have a new one, just stop talking.”
The challenge for those facing the extremes of repetition by a loved one who is experiencing cognitive impairment is knowing what to do. Family members usually learn to avoid interrupting the recounting of an event with “You told me already” or “I know,” as this may cause conflict with a denial that the conversation has taken place.
In the context of normal aging, family members may find that the retelling of one’s life narrative frequently occurs. This is one way we validate our lives, which is important as the past becomes increasingly important compared to the limited options for the future. This human need to tell our narratives is reflected in the interest by many in writing autobiographies and memoirs and in reading them. Being patient with our narrative-telling loved ones is important to them and ultimately to us.
Be patient and listen
The best recommendation I can make about this inevitable process is to find ways to be patient with your loved one and accept that even though you have heard the story before, acknowledging it and expressing an interest in it is helpful and even therapeutic to both of you, but especially to that aging loved one.
