What should I talk about on my visits with Mom when most of what she says is repetitive nonsense?

My mom lives in a dementia home nearby, and I visit her twice a week. She’s a real talker, but most of what she says is repetitive, fragmented, and doesn’t make sense. It’s hard to just sit there listening to her babbling, but when I try to guide the conversation, it backfires sometimes. For instance, if I bring up what my sister is doing, she thinks it’s HER sister (who died 6 years ago) and asks why she hasn’t visited. Sometimes it feels like I’m talking to a squirrel!

I’d appreciate any tips for how to talk to Mom or at least spend the time in a way she can enjoy.

Talking, listening, and what’s between

You’ve got the right start in visiting Mom frequently. This benefits both of you: it increases the number of happy moments in Mom’s life, and it gives you a chance to see more of her as her days count down.

Silence is awkward, but you don’t have to fill it. The fact that Mom’s a “talker” helps fill the silence, and that makes it easier to treasure the moments and just be. So here’s a dirty little truth: your mom’s probably not following the conversation anyway, so you CAN just be.

Try reacting to what Mom says, but hold back on the details, hold back on memories she may not recall, and just share feelings. As your mom stumbles through trying to tell stories that don’t make sense, react to the little bits of sense that bubble up to the top as Mom rambles. And redirect anything that’s going to take her down a rabbit hole.

Let’s say you mention that your sister adopted a new puppy, and Mom responds by talking about a dog her own now-deceased sister had, then asks why her sister doesn’t visit. It’s not your job to explain that Mom’s sister’s not around any more. Instead, change the subject back to dogs, how you like puppies, and maybe even show her a Dodo video (a YouTube channel that focuses on cute animals) with puppies. Tell her how delightfully cute they look. Chances are that Mom will react to your joy, feel happy, and forget about her sister, because at this stage of her life, that’s how her mind works. So let’s recap: talk about happy feelings, show happy feelings, and share happy feelings.

Dealing with the nonsense

You mentioned that Mom’s conversations are repetitive, fragmented, and don’t make sense. Up to a point, that’s okay. But there are things to consider:

• Mom’s repetition may mask some kind of discomfort. Check her out to make sure she’s not in pain, too hot, too cold, hungry or thirsty. Have her make a trip to the bathroom. Look for signs of rashes, sores, or something else she might not be aware of. She may also not know how to express the discomfort, so look for external signs. If she’s wearing a sweater when the room is 85 degrees, tell her you’d like her to try on a new one, take the old one off, hang it up, and stop there. Bring cookies or chocolates on your visit and take them out of your purse, eat a bite, and ask her what she thinks of the taste. You may actually have to do it this way to cue her that eating is the thing to do. If she’s hungry and capable of eating, she will. If not, don’t press the issue. Also, DON’T say “I already told you that” or anything that makes her aware of the repetition.

• Mom’s repetition may be a sign of low blood sugar. My type 1 diabetic husband says that when his blood sugar is low, he sometimes experiences “puzzle dreams” both when asleep and awake, and I’ve noticed it leads to unproductive, perseverative behavior.

• Mom’s repetition may be a sign of anxiety. If Mom appears anxious about remembering something, don’t hesitate to put up signs and reminders, like “dinner is at 6:30” or “This is Mrs. Templeton’s room.” If Mom thinks those are silly, tell her it’s to remind other people who aren’t as sharp as she is. Mom’s environment may also be too noisy,too bright, or too stressful. Try moving her to a quieter, dimmer place. But there’s probably no way you’ll ever figure out what she’s anxious about, and she won’t be able to tell you, so the best you can do is replace the anxiety with a happy, comfortable environment, events, and interactions.

• Conversely, Mom’s repetition may be a sign of boredom. If she’s up for it, bring an easy task she can focus on. I used to take a box of beads with me on my visits with Mom and ask for her “help” to “sort” them for a “craft project I had.” None of that was true, but it helped keep her calm, busy, and focused when she was at loose ends.

• Mom’s excessive talking may be a way to soothe herself, perhaps to fill the silence. Her thinking is muddled and slow, and finishing sentences for her might just be frustrating. Let her stumble through saying what she wants to, and if she can’t remember what that was, tell her it will come back to her later. Try NOT to switch subjects or interrupt if she’s not getting upset or “going to a bad place.”

• Mom’s nonsensical language may simply be a sign of brain damage, and there’s not much you can do but be patient, reassuring, and share simply, quiet, happy moments with her.

• Mom’s repetition and nonsense may be due to medication. Pay attention to whether Mom’s nonsense and repetition occurs during a particular time of day, under particular circumstances, or in the presence of particular people. If Mom’s anxious, get her away from the triggers. And if it’s dependent on the time of day, take a look at her medications. Some medications may cause her behavior when they’re most active in her system, or others may cause the problem when they start to wear off. For other medications, her behavior may be a side effect.

When all else fails

Speak slowly and wait for Mom to respond, and don’t point out that she’s repeating herself. If she’s still anxious, find something she’ll enjoy and distract her.