How can I get my mother with Alzheimer's to stop picking her skin?

D'sgirl asked...

My 82 year old mother has Alzheimer's and has developed (and it is getting worse!) a frightening and potentially dangerous habit. She sits for hours picking the skin off any part of her body she can reach. Her arms look like chopped meat and she has ruined most of her clothes with blood. She has made sores on most every part of her body; face, arms, hands, neck, back and chest. Not only does she pick the skin till it bleeds, when scabs form, she picks those off and gouges deeper. Her doctor is aware of this and we have tried several medications with no help. I have taped, wrapped, bandaged, and gloved. She always manages to get them off and continue digging. Does anyone have any suggestions. I keep antibiotic ointment on all of the places and keep them clean, but I need some ideas other than keeping her so drugged up that she can't function, how ever little it is Thanks!

Expert Answer

Joanne Koenig Coste is a nationally recognized expert on Alzheimer's care and an outspoken advocate for patient and family care. She is the author of Learning to Speak Alzheimer's. Also, she currently is in private practice as an Alzheimer's family therapist. Ms. Koenig Coste also serves as President of Alzheimer Consulting Associates, implementing state-of-the-art Alzheimer care throughout the United States.

This must be devastating for you as a caregiver to watch your Mom repeatedly performing an act that can potentially become a grave medical problem. It is difficult enough to deal with Alzheimer's without the addition of this ongoing habit. I'm sure it is also less than pleasing to be viewing this ritual and its bloody results day after day. It does sound like you have done all the right things in seeking your physician's help and in attempting to cover her hands to prevent the dreaded scratching. In the hundreds of Alzheimer's disease folks I've seen in the past 3 decades, I must admit to only knowing a few who have manifested this same seemingly harmful need to scratch at areas that have been tested and show no underlying skin irritation or allergy which would be the first consideration. I have also seen several others with as dementia-related psychiatric illness. I'm sure your physician has already checked this possibility as the trigger for the picking. Having ruled out medical, psychiatric, or dermatologic causes, I would suggest you try a different kind of clothing that has worked well for the other patients to whom I previously referred. It is a one piece garment that fastens in the back and leaves the person's skin totally covered; because of the back closure your Mom would not be able to remove it.
I would also suggest a "busy apron" which is, exactly as it sounds, an apron that is worn over the back-fastening garment and has items attached that keep the person wearing it busy interacting with various buttons, textures, zippers etc. Not only does it provide some healing time but it may hopefully redirect her focus onto something other than her skin. Try "The Alzheimer Store" online to find the articles I mentioned or for assistance in finding a place near you that has them in stock. If you or a friend are handy with a needle and thread, do buy some interesting objects and sew them onto a cobbler-style apron to create your own version of a busy-apron. Be sure to take care of yourself!