Dementia can be a difficult condition to manage, for patients, caregivers and their family members. Along with memory loss, there are a slew of other dementia behaviors that can make life difficult. One of the most challenging symptoms of dementia can be skin picking and scratching, which can lead to serious infections.
For many older patients with dementia (or Alzheimer’s disease), the urge to scratch can become overwhelming, leading to skin irritation and even infection.
In this article we’ll discuss some tips on how to stop dementia patients from scratching. We’ll also provide some information on the potential causes of this urge, and what you can do to help your loved one manage it.
But if you’re struggling to stop a dementia patient from scratching, it’s important to seek professional help. A doctor or other healthcare provider can offer additional tips and strategies, as well as provide medication if necessary.
With the right approach, you can help keep your loved one comfortable and prevent further damage to their skin.
Dementia And Excessive Scratching
I remember a patient of mine who had a history of excessive scratching. Her skin was always raw and she had scabs all over her body, but especially her lower legs. She also had dementia.
When I asked her why she scratched so much, she told me that she “felt bugs crawling on her skin”. I explained to her that there were no bugs, but her dementia prevented her from comprehending what I was saying.
It can be difficult to convince someone with dementia that they are not actually feeling bugs crawling on their skin, especially if they are experiencing delusions or hallucinations.
In this case, the best course of action is to try to calm the person down and distract them from the sensation. If the scratching is excessive and causing injuries, you may need to cover the person’s skin with a light cloth or garment to prevent them from harming themselves.
If your loved one has dementia, understand that their brain structure has changed and that they may not be able to control their emotions or impulses as they once could. The most important thing you can do is show them patience, love, and understanding.
Also know that itchy skin and scratching are not just common among seniors with dementia, it is also quite common amongst the elderly population.
With increasing age, there’s an accompanying decline of normal immune function that results in a higher frequency of autoimmune skin disorders (eg, bullous pemphigoid) that may lead to pruritic symptoms.todaysgeriatricmedicine.com
Dementia patients may scratch their skin obsessively due to a number of root causes. The most common reason is simply because they feel itchy. However, some experts believe that excessive scratching may also be a way of self-soothing or dealing with anxiety.
There are two medical terms associated with this issue:
- Senile Pruritus
This condition is also known as skin-picking disorder or excoriation disorder. It’s an aggressive behavior that is characterized by repetitive, compulsive picking at the skin that leads to damage. This can happen anywhere on the body but is most commonly seen on the face, arms, and legs.
It’s not seen just in seniors with dementia, individuals with Parkinson’s disease, depression, severe anxiety, attention deficit disorder and hyperactivity disorder as well as Alzheimer’s disease can all develop Dermatillomania.
Also known as excoriation disorder or skin-picking disorder, this condition falls under the category of obsessive-compulsive disorders (OCDs). When it leads to significant scarring and injuries, this condition can severely affect a person’s mental health, well-being and quality of life.clevelandclinic.org
This is a condition that’s specific to the elderly population. It’s characterized by itchiness that can’t be explained by any other underlying condition. In some cases, the itchiness is caused by dry skin. In others, it may be due to nerve damage. Senile pruritus can be extremely uncomfortable and can lead to further skin problems, such as infection.
Senile pruritus is one of the most common conditions in the elderly or people over 65 years of age with an emerging itch that may be accompanied with changes in temperature and textural characteristics.Wikipedia
Whatever the reason, it’s important to try to identify the underlying cause and then find ways to reduce your loved one’s scratching. Although this is a fairly common issue in elderly patients, it’s important take care of it right away. It most likely will not get better without intervention.
What Causes Itching In Dementia Patients?
There are many possible causes of itching in dementia patients. They are not all obvious causes.
Medically, it could be a side effect of medication or even a sign of an underlying health condition such as liver disease or kidney disease. If they are scratching around their genital area, they may be suffering from urinary tract infections. If they are scratching their foot, it may be a result of athlete’s foot. Other skin conditions such as eczema and psoriasis can also be contributing.
Environmentally, it could be allergic reactions to a new laundry detergent, new bar of soap or a new piece of clothing that they are wearing. It’s a good idea to try to keep using the same types of soaps, clothing and lotions as much as possible.
Psychologically, as I mentioned earlier, the scratching could be a response to anxiety, compulsive behavior or a way to soothe themselves. After all, it can be extremely frustrating for someone with dementia to deal with the confusion that they are experiencing.
Compulsive behaviors are common in dementia patients. This can manifest as compulsive skin picking, which can lead to open sores and infection. It’s important to try to redirect the behavior if possible, and to keep the person’s nails trimmed short to minimize the risk of injury. If the behavior is severe, it may be necessary to consult with a doctor or behavior specialist.
Itching can also be a common symptom of depression. If your loved one is feeling anxious or down, they may start to scratch more frequently. This can actually make the itching worse, creating a vicious cycle of discomfort.
If your loved one is experiencing a severe itching sensation, it’s important to talk to their doctor to rule out any serious causes and find the best way to relieve that annoying itch.
Itching can be a frustrating and distressing symptom for dementia patients and their caregivers. By understanding the possible causes and taking steps to prevent and treat it, you can help your loved one feel more comfortable and keep their skin healthy.
Why Do People With Dementia Scratch So Much?
For people with dementia, the urge to scratch can be overwhelming. It’s not uncommon for them to scratch their skin until it bleeds. They may not even be aware that they are doing it.
There are a few possible explanations for this behavior. One is that dementia often causes changes in the way the brain processes sensations. This means that people with dementia may feel more itching and pain than people without dementia.
So, although they may not actually have dry skin or psoriasis or eczema (aka atopic dermatitis) or any other skin condition that is causing them to itch, they may still feel that their skin is itchy and scratch it anyway.
Another possibility is that people with dementia may scratch because they’re anxious or bored. Scratching can provide a temporary sense of relief from these feelings.
Anxiety and agitation may be caused by a number of different medical conditions, medication interactions or by any circumstances that worsen the person’s ability to think. Ultimately, the person with dementia is biologically experiencing a profound loss of their ability to negotiate new information and stimulus. It is a direct result of the disease.Alzheimer’s Association
If you’re concerned about someone with dementia who is scratching their skin, talk to their doctor. They can help rule out any underlying medical conditions that may be causing the itching. They can also provide suggestions for how to manage the behavior.
How Does Dementia Affect The Skin?
Dementia can cause changes in the skin that can lead to problems with hygiene, infections, and pressure sores. The skin may become dry, thin, and bruise easily. There may also be changes in sensation, so the person may not feel pain as well. This can make it difficult to care for the skin properly.
To help care for the skin of someone with dementia, it is important to keep the skin clean and moisturized. The person should also be protected from injuries and pressure sores. Proper nutrition and hydration are also important for keeping the skin healthy.
The type of moisturizer you would use would depend on whether or not the skin is dry, or has eczema or psoriasis, etc. So, speak with your doctor or better yet, a dermatologist first. They may recommend topical corticosteroids or some other topical medications.
Pressure sores are very common amongst seniors and should be treated immediately. Here are some products that can help protect someone from developing them.
Hydration is extremely important and sometimes very difficult to get into someone with dementia so if water is not to their liking, encourage eating foods that contain water such as…
- skim milk
- plain yogurt
Speak to a nutritionist or your physician about ways to keep your senior loved one hydrated to help prevent dry skin.
Also, diets in older people that are deficient in Vitamin C and protein can certainly impede the healing of any pressure sores.
Tips On How To Stop Dementia Patients From Scratching
If you are the caregiver of a dementia patient, you know that one of the most challenging behaviors to manage can be repetitive scratching. While this may seem like a small problem, it can actually cause serious skin damage and lead to infections.
Here are some tips on how to stop dementia patients from scratching:
- Keep the nails short and clean. This will help reduce injury to the skin.
- Pay attention to their personal hygiene and make sure they are clean and dry.
- Keep on eye on the time of day that your loved one seems to start scratching or do the most scratching. This may help to identify the potential trigger.
- Apply a lotion or cream to the skin daily or twice a day. This can help soothe the itch and also make the skin less sensitive to touch. Some type of hydrocortisone cream or calamine lotion may help.
- Use a distraction technique. When the patient starts to scratch, try to engage them in another activity. This can be anything from talking to them, reading aloud, or even playing a game.
- Keep their hands busy with purposeful tasks such as folding laundry, polishing shoes, helping to prepare a meal, etc. Or with activities such as games, puzzles, painting, coloring, etc. Read about more tasks to help keep them busy.
- Try having them wearing gloves. This can help protect the skin from further damage.
- Try to keep the environment calm and relaxed. Stress can worsen the urge to scratch, so it’s important to create a tranquil atmosphere.
- Apply ice packs to the affected area or areas.
If you have tried these tips and the scratching persists, it is important to consult with a doctor or dermatologist. They may be able to prescribe medication to help ease the itch or suggest other treatment options.