What to do when elderly father (who is reasonably cognitively intact) engages in perseverative-repetitive behavior?

Starting an activity, but some fauty brain signals interrupt the flow & cannot stop. I've seen this with dementia & OCD many many times. Needs verbal, physical or often visual prompts to transition to new activity.

Eg when toothbrushing has been done for 2 mins, then wave the cup to rinse. Then wave the towel to dry mouth. Then lead out of the bathroom & engage in next activity. Staff are paid to do this in MC -all-day-long.

Check out Teepa Snow's info on dementia - especially Emerald stage'.

Let him be. Don't correct him or remind him of what he is doing wrong. Of course it causes agitation. Reading the same page for an hour, don't let concern you, it is not hurting anything.

Are you, perhaps, thinking that if you correct him it will change the behavior next time? It won't; correcting him and hoping it will change his behavior will only cause you frustration. Learn to let go.

Imho, unless this OCD type behavior is detrimental to his well being, perhaps you should dismiss it because, after all, your father is 96 years of age. If reading pages in his prayer book a little too much/not turning the page, wherein lies the harm? Other than overbrushing his teeth and causing problems with his enamel, at least he IS brushing them. You could always pose this question to his dentist or dental hygienist.

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?

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.

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.

Please try to limit your efforts only to behaviors that are detrimental for his health. Diversion is usually helpful. Don't tell him that he is repeating himself since it only tends to reinforce the behavior. Try getting him to focus on something else by stimulating his senses: play music, start a movie he likes, pop a favorite snack in the oven so he smells it.... Also try inviting him to do something with you: watch a movie, play a game, read the paper... If diversion does not work, please consult his doctor for further evaluation and treatment.

Others have said that if praying brings him peace, then let him pray. Maybe it will help him nap.

I'm going to flip the page and say that if he starts believing God is giving him "spiritual revelations" (of the crazy sort) then it might be time to redirect perhaps by listening to scripture readings or worship music.

Unless it is dangerous leave him to it - this is obviously bothering you far more than him. It doesn't matter what he does with his time as long as he is not causing himself any risk.

His doc should evaluate him and if necessary refer to neuro who specializes in dementia. Let him do the activities. Learn to pick your battles and let everything else slide. Those battles should be about keeping him safe from harmful activities.

Let him pray and read for whatever time he wants - what does it hurt. Its good that he is practicing good oral hygiene which can go by the wayside with dementia.

If his behavior is due to dementia you and bro will need to plan ahead for dad's future and if his current activities upset you, just wait. Do your research and be very flexible in dealing with dad. As long as its safe let him do what he wants to do.

Good luck and best wishes.

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.

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.

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.

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.

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.

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.

I would say there is some Dementia here. Get him a good checkup with labs.