Expert: Mary Gordon - 3/28/2010

Question
My Mom who is 92 and has dementia/AD hangs on to her opposite hand and twists on her fingers, sometimes to the point that she says 'ouch'.  She continues this activity for many minutes at a time.  She also often tries to nibble on her fingers or thumb.  It almost seems as though she has something in her hand that she is eating.  Is their significance to this activity?  Should I try to distract her from doing this?  I sometimes can successfully substitute her Teddy Bear to hold onto.
Thank you so much for your time.
Fran

Answer
Hi Fran,
The concern I have is that she will hurt herself. What you are seeing is a form of agitation behavior - i.e. picking, chewing, pulling, fidgeting, pacing, repetitive motions.  

My mother in law used to go after any little imperfection in her clothing or the arms of her wheelchair. She'd find a little loose thread or bump, and pick and pick until she had the entire thing unravelled and pulled apart in short order. Some people get into picking at their skin or scratching.

If your mom continues to twist and chew on her fingers, I think inevitably she is going to create breaks in the skin, with the risks that continued worrying and picking at it will prevent healing and lead to infection or other damage. Have you tried getting her something to keep her hands busy - such as an activity apron or pillow?

Here are some samples of the kind of product out there - you could even make your own. There are all kinds of this type of product available because figeting, pulling, tugging, picking is fairly common.
http://alzstore.com/Alzheimers/denim-activity-lap-pillow.htm
http://alzstore.com/Alzheimers/fiddletwiddles.htm
http://alzstore.com/Alzheimers/activity-apron.htm
http://www.posey.com/Posey/Therapy-and-Ambulation/Hand-Therapy-Products/Posey-Ac...
I've also seen a number called "fidget quilts".
Or you could try something like this
http://toys.pricegrabber.com/stuffed-animals-plush/Woodours-Baby-Activity-Bear/m...
which might be more attractive to her - and does involve a teddy bear like you say she likes a bit.   It's worth a try.

If you can't distract her from the pulling and chewing or give her a substitute, you might have to consider a mitt for one or both hands (i.e. an oven mitt taped at the wrist so she can't get it off. You might also want to talk to her doctor about anti-anxiety or anti-depression medication, which sometimes helps with this kind of thing.  

Thinking of you. Hope this helps.

Mary