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When 'Picking' at Things Becomes an Issue with Alzheimer's

Posted by on 10/11/2015

At the middle stages of dementia, the person becomes less aware of the surroundings and what is going on around him or her. The focus, instead, is on things that are in a narrow field of space around the person. You may have heard or read that you should approach a person with Alzheimer's from the front and to get eye contact before speaking. This recommendation comes from the knowledge that the world the person attends to, does shrink as the disease progresses. Approaching a person from the front and making eye contact, helps to not startle the person and to get their attention before speaking.

A behavior that can - but not in all cases - occur in this stage, is the person picking at things. It could be picking at lint or trim on clothing. But sometimes it is the person picking at his or her own skin or hair, which can turn into scabs and bleeding or bald spots in the hair. Suggestions I have heard to try to manage these behaviors, include making sure the person's skin is not dry and itchy. Applying lotion and having the person drink enough water might help. Also, putting long sleeves over the arm or a hat or scarf over the head being picked at, might help. These are good ideas and can alleviate the issue, sometimes.

However, another approach is based on the knowledge that the world the person attends to at this stage of dementia is more narrow. Because the person is attending primarily only to things that are within arms reach in this more narrow world he or she is living in, it makes sense that he or she might see a scab or arm mole and decide to 'get to work on it' - i.e. pick at it. So another solution to try, involves giving alternative items that the person can use their hands to manipulate and fiddle with and/or move around. Some examples include:

  • Sorting buttons by color or placing them into a case with slotted, individual storage areas.Ask-the-OT-picking-with-dementia.jpg
  • Sorting nuts and bolts
  • Moving and arranging items in a fishing tackle box (all hooks removed)
  • Looking at and shuffling torn out pages from a recipe book
  • Folding or rolling hankies, cloth napkins, or men's ties
  • Polishing shoes or silverware with a safe polish material
  • Setting a very simple, large piece puzzle
  • Rolling dough balls for cookies

Note, at this stage, the person needs continual help and supervision. Some may try to put non-edible items into the mouth, so monitor all objects the person uses to ensure they are not put into the mouth.

Giving the person with Alzheimer's an alternative way for the person to use his or her hands in a more positive way can help the person use their energy in a good way and avoid picking at the skin, head, carpeting, etc.

To learn more about how to handle difficult behaviors, see The Caregiver's Guide to Dementia: Using Activities and Other Strategies to Prevent Reduce and Manage Behavioral Symptoms


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0 Comments

Ayse Kucukkoylu
Date: 7/9/2016
I'm dad's care thanks for the info
Karen
Date: 10/26/2017
Thank you. My mother has dementia and used to pick at her scalp before but now she has scratched her head in the front and created a balding short hair patch. She has progressed, if you can call it that, to nose picking and teeth picking. She seems very disinterested in fidgit spinners and such but a stretchy head scarf works to get her to scratch the scarf and not her head!
MindStart
Date: 11/2/2017
Thanks for the comment Karen. You could also try bubble wrap to manipulate, a pillow with lots of fringe or beads (just monitor that they don't break off), blanket with a fringed end. Your head scarf idea was great!

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