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 Sherard practiced as a speech-language pathologist and had various roles in the neurorehabilitation field for 25 years, including management and serving as President of the Board of Directors of the Brain Injury Association of South Carolina. She continues as a consultant in the brain injury rehabilitation field as well as advocacy endeavors.