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My brother and I (partnering in full time caregiving) are at a loss with how to handle our 96 year old father when he engages in a behavior in a perseverative-repetitive manner for a long period of time. These behaviors are limited to 1-2 a day, for example, praying in morning and reading same page in prayer book for an hour or more, brushing his teeth and-or rinsing his mouth for more than 30 minutes. If my brother or I attempt to stop him and go the logical route by trying to explain to him that he has been performing the action for an excessive amount of time, he becomes livid and seems to be jumpstarted to start the behavior all over again...so we don't know what to do. Any similar experiences, any suggestions? Thank you all in advance.

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Why are the actions you gave such an issue?

So what he reads the same page for an hour. Thankfully he even brushes his teeth.

Learn to let it go and let him do what he wants as long as it doesn't create a safety issue.

His getting livid is an appropriate response to being controlled when no control is needed.
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JoAnn29 Aug 2021
My Mom would sit with a book and look like she was reading but never turn the page. If this is something new, itcshould be checked out.
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Some OCD type tendencies are common.
for the most part let them go.
Make sure you switch his toothbrush to a Soft one so he does not damage the teeth. Switch to Non Fluoride toothpaste and a non alcohol mouth wash. This is incase he begins to swallow the toothpaste or rinse.
As for the praying, if it brings him peace or he is calm ding it leave him to pray.
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graygrammie Aug 2021
I would add that perhaps an electric toothbrush could be helpful, just keep it slightly charged so that he can brush for a few minutes before it dies.

I know too much brushing can damage the guns, especially in older people.
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Make an appt to have him screened and clinically evaluated for dementia by his physician. Educate yourself about dementia symptoms and what causes them. The first thing you'll learn is to stop challenging your dad, or trying to explain his behavior to him. Search for dementia in your local library or on YouTube. There is a plethora of information.
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Something has changed in your father's brain.

I would report this new behavior to his PCP and get a referral to a neurologist.

If he doesn't have a PCP, try to find a geriatrics doc you can take him to.
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If he is relatively peaceful and calm when performing his repetitious actions, is there any other reason why you and your brother feel you need to change it or stop it?

“Logic” is not working to help him, and employing it seems to be disturbing to you.

What are you referring to as “reasonably cognitively intact”. Has he been assessed by a professional trained in geriatrics?

If you are going by the screening type tests used by PCPs to identify gross cognitive decline, he may have been able to perform at a passing level, but still have deficit areas that can be causing him difficulty.

He may also be using his actions as a release from anxiety.

He may respond positively to medication, if his testing reveals such needs present.
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He's 96. I wouldn't investigate this aggressively at this stage, with just these behaviors (which sound like the deepening of already entrenched personal routines). What for?

Bgbn, how long have you and your brother been taking care of your father?
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I would say there is some Dementia here. Get him a good checkup with labs.
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My dad (does have dementia) counts the ceiling tiles. All day, constantly. He will gently push me out of the way if I’m blocking his view of his current count. I’m about 90% sure his is a medication side effect, and he needs the meds for agitation, so I let it go. But I would mention it to his doctor if I were you.
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For the teeth, you could try an old-fashioned egg-timer, or get him an electric toothbrush with an alert that tells you when to stop. He might ignore them, of course, but it's worth the effort because you can do your gums and enamel a power of no good by overbrushing.

Reading the same page of the prayer book - perhaps he doesn't feel satisfied unless he's done it "perfectly" (whatever perfect is to him).

In any case don't intervene unless there is an identifiable need to.
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I agree with others in that he should have a full medical check up with labs and a possible referral to a neurologist. If the actions you described are new , something has changed for him. I wouldn't attempt to try "logic" on him at this point as your logic is not the same as his. Switch to a softer toothbrush and non alcohol mouth rinse (don't want to damage his teeth); if he stays on the same page in the prayer book for an hour... there's no harm done to him or the rest of the world. I would document his behaviors and the times for his PCP and the neurologist to give them a full picture. Once you get a diagnosis from the doctors, you can start to research further and learn better how to cope. And of course, you can always come here with questions, concerns or just to vent.
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