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Elaine Phillips, BrainLine
My wife had a brain injury in a car crash more than 1 1/2 years ago. She gets stuck easily on a subject and asks the same thing over and over. She might ask when we’re going for a walk 20 times. I try not to get frustrated but I’ll answer her and what seems like seconds later, she’s asking me the same thing. If I get impatient, things get worse. Why does she do this and what can I do to help?
You are describing perseveration, which can be defined as repetitive and continuous behavior, speech or thoughts that interfere with everyday activities. After a brain injury, perseveration is often related to damage to the frontal lobes. A person may have difficulty changing topics, as you describe, or may even persist with using a strategy to solve a problem when it is clear the strategy isn’t working. This is called stuck-in-set perseveration.
This “stuckness” is often one symptom of problems with attention and memory, mental rigidity, and other cognitive skills. Anxiety can make symptoms worse. People who have had a brain injury often find changes in routines or schedules challenging.
Your wife is not perseverating on purpose. You can help by being reassuring, sticking to the same routine, and letting her know in advance of any changes. You can also try to change the subject by redirecting your wife to a new activity in another room. Because the perseveration is likely out of your wife’s control, it’s important to realize that ignoring her questions may increase the problem. If you feel the perseveration is related to anxiety, you may wish to discuss the possibility of medication with your physician. Because perseveration can be exhausting to deal with, you should also make personal time to refuel your energy and care for yourself.
Elaine Phillips, MSP, CCC-SLP has more than 17 years of experience in the field of brain injury, both as a speech-language pathologist as well as managing the outpatient brain injury rehabilitation program at Roger C. Peace Rehabilitation Hospital in Greenville, SC.
In addition, she is a Certified Brain Injury Specialist-Trainer and is Board President of the Brain Injury Alliance of South Carolina. Elaine is the research consultant for the BrainLine project.
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Comments [4]
I am also a car accident survivor (going on 2yrs on Feb. 14, 2010) and have a brain injury, with my injury specifically being in my right frontal lobe. This is my first time on this amazing site and the first question/answer I read. My fiance and I read it together and were so amazed at how similar this question is to our lives together. The answer to this question was very helpful in explaining WHY I act the way I do at times. My fiance realized that when he does get impatient with me I my difficulties definitely become worse. To the writer of this question from a woman with a brain injury, I will tell you that it is extremely difficult to live with a brain injury, but also very difficult (from what I can see) to live with/love someone who has a brain injury. The key to success is patience, time, faith, support, and coping strategies. My doctors told me that my memory would not get better, but definitely has over time and my repetitive question asking has significantly decreased. Also, taking medications for my memory has helped very much. As for coping strategies with my fiance...we have been through many trials of various strategies. What works best for me is for him to touch my arm or hand and very patiently tell me that I already asked him the same question, but he will answer it again. We sometimes will write down the question and answer together. My fiance will at times jog my memory by saying something ie "Do you remember that we wrote down some information about... on the white board". As long as he is patient with me and continues to jog my memory, and I continue to work on myself by using my own coping strategies that I have learned over time, things seem to go smoothly and my cognitive skills seem to get better. GOOD LUCK with everything!!!
It will help to develop coping strategies. For example, when she asks it the third time, answer by suggesting that she write it down on a note board. You can get white boards with double sided tape to stick to your refrigerator. This can be the place where memory issues are posted. These lists and notes can be a big help to the both of you. You may benefit from attending a brain injury support group or if there are none, a stroke or dementia/Alzheimer's support group. My father carried a note pad in his pocket and would write these things down and look at them often. My wife uses the white board for me and my mTBI/PCSs You both need help with coping strategies, work-arounds, and accommodations. Maybe you can find a copy of 365 Tips and Techniques for Living with a Brain Injury. I think you can get it on Amazon. There are other helpful books available too.
Wonderful Article, I emailed it to my husband (as we had this topic come up this past weekend!). I also posted this on Facebook and my group for TBI's and Women. THank you!
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My 9-year-old has a brain injury and does the same thing. Her perseverations can be about buying a stuffed animal, buying a new dress, going to a certain place, etc. The question I have is what can we do to discourage the perseverating? We have tried telling her that she is allowed to discuss the subject for 10 minutes, then we have to talk about other things. That works occasionally, but it can still last for days and days. Help?
Mar 7th, 2011 8:58am