Why do old people play with tissues? Understanding the Causes of Repetitive Behavior

Oct 26, 2025 4 min read •

senior care Healthy Aging dementia

According to the Alzheimer's Association, repetitive behaviors are common in people with dementia and other cognitive impairments. Observing an elderly loved one constantly fidgeting or why old people play with tissues can be confusing and concerning. This guide explores the underlying causes and provides compassionate insights.

Quick Summary

Repetitive behavior like manipulating tissues can be a symptom of cognitive decline, dementia, anxiety, boredom, or a way to seek sensory comfort. The action is often a subconscious way for an individual to self-soothe or occupy restless hands, rather than a deliberate action with intent.

Key Points

Anxiety Relief: Repetitive tissue handling can be a subconscious coping mechanism to reduce anxiety or stress in seniors facing significant life changes or cognitive decline.
Neurological Symptoms: In individuals with dementia or cognitive impairments, playing with tissues can be a symptom of memory loss, disorientation, or sundowning, reflecting neurological changes.
Sensory Need: The tactile experience of handling a soft, pliable object like a tissue can be a form of self-soothing, providing comforting sensory stimulation for restless hands.
Occupying Boredom: For some seniors, the behavior simply serves to occupy idle hands and a mind that may not be fully engaged, especially during periods of quiet or inactivity.
Compassionate Approach: Caregivers should never scold or forcibly stop the behavior but instead focus on understanding the cause and gently redirecting the person's attention with safe, alternative activities.
Consider Medical Factors: It is important to rule out medical causes, such as medication side effects, that might be contributing to restlessness or compulsive behaviors.

Unraveling the Repetitive Behavior

For family members and caregivers, observing a loved one engaging in repetitive behavior, such as constantly folding, tearing, or simply handling tissues, can raise many questions. This isn't a random habit but a complex behavior rooted in various psychological, neurological, and physical factors. Understanding the 'why' is the first step toward effective and compassionate care.

Psychological and Emotional Factors

Often, the answer to "why do old people play with tissues?" lies in their emotional state. As individuals age, and particularly if they face cognitive decline, they may experience increased anxiety, stress, or loneliness. Handling a familiar, soft object like a tissue can serve as a form of comfort or a coping mechanism.

Anxiety and Stress: The act of fidgeting can be a physical release for pent-up anxiety. Just as some people tap their feet or twirl their hair, manipulating a tissue is a simple, repetitive motion that can feel soothing and reduce feelings of nervousness.
Boredom and Restlessness: In many care settings or during periods of quiet, seniors may experience a lack of mental and physical stimulation. The hands, having been active for a lifetime, can feel restless. A tissue provides a readily available, harmless object to occupy them.
Habit and Routine: The behavior might be an ingrained habit that provides a sense of normalcy and routine when other parts of life become unpredictable. The muscle memory of performing a simple task can be reassuring.

Neurological and Cognitive Causes

More serious causes for this behavior are often linked to neurological changes. Dementia, including Alzheimer's disease, significantly alters how the brain processes information and manages impulses.

Dementia and Cognitive Decline: As short-term memory fades, individuals may perform tasks repeatedly without realizing they've already done them. For example, they might pick up a tissue, use it, and then pick up another, forgetting the previous action.
Sundowning Syndrome: For some with dementia, these behaviors intensify in the late afternoon or evening. The confusion and anxiety of "sundowning" can lead to increased fidgeting and repetitive actions as a way to cope with disorientation.
Object Recognition Issues: Due to cognitive changes, a person might mistake one object for another or become fixated on a single item. A tissue, being soft and pliable, might feel comforting, or they might simply be unable to process what the object is or what its function is, leading to endless manipulation.

The Role of Sensory Stimulation

For many, especially those with sensory processing issues common in advanced age or dementia, tactile feedback is important. The sensation of a tissue is a key component of the behavior.

Comforting Texture: The soft, crinkly texture of a tissue can provide a pleasant sensory experience. This tactile stimulation can be a simple, calming pleasure when other forms of engagement are not possible.
Occupying the Hands: When the mind is less occupied, the hands often seek something to do. Offering alternative sensory objects can sometimes redirect this need effectively.

Medical Explanations and Medication Side Effects

While less common, some medical factors can contribute to repetitive behaviors.

Medication Side Effects: Certain medications, particularly those for anxiety, depression, or even Parkinson's disease, can cause restlessness or fidgeting as a side effect. It's important to consult with a doctor to review all medications if the behavior is new or worsening.
Physical Discomfort: An individual with arthritis or other physical ailments might find the light, repetitive action of handling a tissue to be less painful than more complex tasks, serving as a distraction from chronic discomfort.

How to Respond Compassionately

Rather than stopping the behavior, which can cause distress, caregivers should focus on understanding and redirecting it. Providing a safe, alternative outlet for this energy is key.

Provide an Alternative: Offer a different soft or tactile item like a soft cloth, a stress ball, or a fidget blanket. This provides the desired sensory input without the potential mess of shredded tissues.
Redirect Their Focus: Gently engage them in a different, more interactive activity. A simple task like folding laundry, looking at a photo album, or listening to music can shift their attention.
Investigate Triggers: Pay attention to when the behavior occurs. Is it during a specific time of day? Is it during a stressful event, like mealtime? Identifying triggers can help you proactively manage their environment.
Consult a Physician: If the behavior is new, significantly changed, or causing distress, it is always wise to consult with a healthcare professional. They can rule out any medical causes or medication issues.


Reason for Repetitive Tissue Use	Potential Signs to Observe	Recommended Caregiver Action
Anxiety / Stress	Increased pacing, agitation, or restlessness. The behavior worsens in unfamiliar environments.	Offer a weighted blanket or calming music. Provide gentle reassurance.
Dementia / Cognitive Decline	Forgetfulness, difficulty with short-term memory, sundowning. Behavior is consistent over time.	Do not correct or scold. Redirect gently with a simple, familiar activity.
Boredom / Restlessness	Occurs during long periods of inactivity. The person seems disengaged.	Engage them in a simple task like folding towels. Introduce a fidget item.
Sensory Need	The person seems calmed by the act itself, focused on the texture.	Provide a sensory mat or a soft cloth with an interesting texture.

Conclusion

Observing repetitive behavior can be challenging, but understanding the root causes, from psychological needs to neurological changes, empowers caregivers to respond with empathy rather than frustration. Addressing the underlying issue, whether it is anxiety, boredom, or a symptom of dementia, is far more effective than simply trying to stop the behavior itself. By providing comfort, redirecting attention, and seeking professional guidance when necessary, you can ensure your loved one feels understood and supported.

For more information on understanding and managing behavioral changes in dementia, please visit the Alzheimer's Association website.

Frequently Asked Questions

There is no single reason, but it is often a symptom of anxiety, boredom, or neurological conditions like dementia. The act provides sensory comfort and can be a repetitive, calming behavior for a restless mind or hands.

It can be, but not always. Repetitive actions are a common symptom of dementia and cognitive decline. However, the behavior can also stem from anxiety or boredom. It's one piece of a larger puzzle, and a medical professional can help assess the complete picture.

Respond with patience and understanding. Instead of stopping the behavior, try to understand why it is happening. Gently redirect their attention with an alternative, safe activity or a different sensory object like a fidget blanket or a soft cloth.

Consider offering a stress ball, a sensory mat with different textures, a soft washcloth, a fidget blanket, or a simple puzzle. The goal is to provide a safe and equally engaging object for their hands.

Yes, some medications can cause restlessness or anxiety as a side effect, which could contribute to repetitive behaviors. It's always a good idea to discuss any new or worsening behaviors with their doctor to review their current medications.

It depends on the context. If the behavior is new, escalating, or accompanied by other concerning symptoms like memory loss or mood changes, it warrants attention. If it is a long-standing, harmless habit, it may be less concerning. Consulting a doctor is always a safe approach.

The tactile sensation of the tissue—its softness and pliability—can be very soothing. For someone with heightened sensory needs or diminished cognitive function, this simple physical stimulus can provide comfort and a sense of calm in a confusing world.

Medical Disclaimer

This content is for informational purposes only and should not replace professional medical advice. Always consult a qualified healthcare provider regarding personal health decisions.