Constant Scratching / Picking at the Skin

Many Alzheimer’s patients scratch themselves bloody — my mother did that.  Sometimes it’s an obsessive/compulsive behavior that’s almost impossible to stop. Other times, though, there is another cause. Among the many tips I’ve seen for trying to help the patient:


First, evaluate the Alzheimer’s patient thoroughly to see whether something may be causing itching.
– Perhaps the patient has developed an allergy to the bath soap s/he uses.  Try different soaps, or perhaps substitute shampoo, instead of soap, to cleanse the skin.  Liquid soaps may be very harsh to delicate skin, so avoid those.
– S/he may also have developed a reaction to a laundry detergent or fabric softener.  Try different ones, preferably without scents or perfumes.
– If a woman’s face itches, it may be due to the makeup she wears.  Try switching to a non-allergenic makeup, or see if she’ll stop wearing makeup altogether.
– Also consider whether face creams or cleansers, perhaps a man’s shaving cream or lotion, might be causing the problem.
– The culprit could be bed bugs, lice, or scabies, all of which are on the rise all across the country; or (if you have pets) fleas.

The problem could be dehydration.  Be sure your Alzheimer’s loved one drinks plenty of fluids, preferably 2 liters of water a day.

Many of the drugs prescribed for dementia patients – for behavioral problems, sleep aids, slowing down memory loss, and depression – can cause severe itching as a side effect.  Other drugs commonly prescribed for older people, for blood pressure, prostate issues and many others, also can cause intense itching.  Look up the potential side effects of each medicine your loved one is taking.  This side effect may be listed either as itching or urticaria. You may find it listed under “Integumentary System.”  One of the best sites for researching side effects is RxList.

If you identify a medicine that can cause this side effect, talk to the doctor about the possibility of discontinuing it for a while, to see if it’s the culprit, and/or switching to a different drug.

An Alzheimer’s patient may develop obsessive-compulsive disorder (OCD) symptoms, although it is fairly rare.  Certain selective serotonin reuptake inhibitors (SSRIs), such as escitalopram, fluoxetine, fluvoxamine, paroxetine, and sertraline, have been found to be helpful for treating OCD patients, and OCD symptoms in frontotemporal dementia (FTD) patients.  Talk with the doctor about the advisability of trying one of these drugs.


Keep any scabs soft with ointment, such as Mupirocin. (Dry scabs invite more scratching.)  Treat open sores with an antibiotic such as neosporin.  Sometimes Alzheimer’s patients will leave bandaids alone, so cover healing scabs with bandaids.  (NOTE:  keep an eye out for allergic reactions to bandaids with latex in them!  Allergic reactions can develop very quickly, and itch like crazy.  All bandage boxes are required to have warning labels if the bandages contain latex, but the warnings can sometimes be very hard to find.  Keep looking until you find something that indicates latex is not in the bandage.)

Tea Tree Oil can help scabs heal and stop the itching.  But be careful when first starting to use this product — it can sometimes be painful.  Watch for signs that the skin is turning red.

Some caregivers have reported success with Pure Aloe Vera Gel.  Be sure to get pure gel, without any lotions or other ingredients.  (If you try using sap from an aloe plant, be forewarned that the sap may stain linens.  Some caregivers have warned that it can also stain the skin a yellow-brown color.)

If the itching is caused by the Exelon patch, remember to put the patch on a different place every day.  Don’t “re-use” the same place for 12 days.  Clean the site well and moisturize the area.  If the itching/light rash persist, some doctors recommend applying Flonase to the skin after removing the patch.  A light coating of a cortisone ointment may also help, but be sure to talk with the doctor before trying this.  Cortisone is absorbed, and it might interfere with some other medicine the patient is taking.  Consult a doctor if the rash persists or spreads, or if the patient develops a rash in any place other than the site where the patch was applied.

Older patients often have very fragile skin.  Frequent bathing may not be advisable.  Switch from a bath to a shower, warm water rather than hot, and only twice a week.  If that doesn’t help, try sponge baths with a no-rinse product.

Keep the skin moisturized. Slather on lotion (people have recommended Eucerin, Aveeno or Cetaphil or other non-allergenic lotions) after each shower while the skin is still moist. Also put lotion on before the Alzheimer’s patient goes to bed. (Accompany this with a massage of the back and shoulders, to make the patient feel loved and pampered.)  Some doctors prescribe a Kenalog/Lubriderm lotion, to soothe the itching and keep the skin soft.

Over-the-counter cortisone cream may ease the itching, but use it only for small areas and only for short periods of time.  If it helps in the short-term but does not break the itching cycle, consult the doctor to see whether continued use is advisable.

Just as tylenol relieves minor pain, it will also reduce the sensation of itching. This can be helpful to break a cycle of itch/scratch or help to determine if there is an actual itch sensation that is causing the scratching. (Be sure to ask the doctor whether it’s okay to give the patient tylenol.)

Make an appointment with a good dermatologist if there’s any rash or redness or any other skin changes.


If no cause for itching can be identified, and nothing you try seems to soothe it, then try other methods to stop the scratching:

Keep the patient occupied; and when s/he is just sitting, keep the hands busy.  Give the person something to hold – small, soft objects to “finger and fiddle” with.  This lessens the picking and gives the skin time to heal.  Some patients like a doll or plush animal.  “Stress balls” come in different colors and shapes, and won’t do any harm if the patient decides to throw it.  “Worry beads” may also work well.

Keep fingernails cut short.  For a woman, get her acrylic nails done, and tell the manicurist to make them very short and very thick – that can make it a bit more difficult for her to “gain purchase” under a scab or loose piece of skin.

See if you can get the patient to wear soft cotton gloves.  Tell a woman they are part of a “spa” treatment – if she thinks she’s being pampered, she may be more cooperative.

If the patient scratches his arms, dress him in long-sleeved shirts, or use “wristies” — elbow length sleeves with elastic at the top and bottom.  The patient may still pick, but at the fabric rather than his skin.  These are sold at websites such as Buck & Buck.

If all else fails, “posey mitts” can be used to give the skin time to heal.  These are sold by many companies … google to find the best bargain.  However, posey mitts are considered to be “constraints”, and may be frustrating and distressful for your loved one.  Only use them as a last resort; and try using just one, on the loved one’s dominant hand, and only during times when your loved one is agitated enough to pick or scratch his/her skin.


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  1. DaveIFM says:

    I was Googling for Alzheimer’s Compendium and up popped this article. Just seconds ago I was watching my wife picking away at age-thingies on her arms. they are little bumps.One had been scratched raw.

    Guess I better start paying attention and rubbing on some moisturizing cream. She has mild diabetes and I am supposed to be helping with moisturizing cream on her feat. I wonder if lotion works as well as creams?

    1. AlzCarer says:

      Dave, my husband’s skin is getting very fragile, especially on his heels, where he may be starting to develop pressure sores. The dermatologist recommended Eucerin Dry Skin Therapy Plus Intensive Repair Body Creme. I had to look around a bit to find it — and in the process discovered that Eucerin offers many different skin care products, for different types of skin problems — but the Intensive Repair Body Creme does seem to get a lot of good reviews. The derm also recommended Neutrogena T/Sal Therapeutic Shampoo, not just for his hair but for his entire body.

      Do ask your wife’s dermatologist whether these products would be appropriate for a diabetic patient, though. It is my understanding that they contain an alpha-hydroxy compound to help slough away dead skin. That’s good for pressure sores — but I don’t know if it’s good for skin problems associated with diabetics.

      Sears apparently offers the Eucerin creme in its stores. Online, several Amazon.com vendors sell the creme. So does Drugstore.com, which has many good customer reviews, appears to be very cost-competitive, and is where I just purchased both the Eucerin creme and the Neutrogena shampoo.

    2. Margarita says:

      Eucerin is not a good product and should not be prescribed, because of it’s content.
      Coconut oil (organic, cold pressed) helps very well.

      This was confirmed by a pharmacist, at her initiative. She was honest, not greedy.

      1. AlzCarer says:

        Eucerin makes many different products. Was she referring to one in particular? My husband’s dermatologist offered us free samples of several different Eucerin products over the years so we could see which we liked best, while my husband was being treated for actinic keratoses and basal cell carcinomas.

  2. Janie says:

    My husband has been scratching his head for months. Have tried all of the shampoos, creams etc. The doctor can’t find any reason for it. Husband says it doesn’t itch but he keeps doing it. He has now scratched a couple of bald spots into his nice thick hair. I tried to get him to wear a hat, that worked for awhile but now he won’t wear it. I have decided to just live with it, he seems to find some kind of comfort in it.

  3. Dena says:

    Janie—I’m on the same page as you—have decided to just live with it. My 98 year old aunt has mild dementia, no outside interests, can’t focus on reading or follow television—-so she sits in her favorite chair and scratches her head for hours at a time. She’s worn a bald spot in her hair and it’s getting bigger. Her hair dresser hides the damage every week, but she tears up her hair style by the time I’ve got her back home. There’s no medical reason, she refuses any and all medication, I suspect she’s incredibly bored, but I can’t do anything about it. She’s never had what one would call an “interior” life or real hobbies and it’s too late now. So instead of getting frustrated and telling her to stop scratching 92 times a day I’ve decided to shut up and let her scratch. I’m telling her other nieces and nephews the same thing: leave it alone. You’re correct that it seems to be comforting behavior.

    1. AlzCarer says:

      Dena, I know this is driving you nuts … but those sores can get infected and cause some serious problems. Have you tried keeping your aunt’s hands busy? worry beads, a stuffed animal or baby doll (which she might find very comforting), an activity apron (there are many different designs available at stores that offer products for dementia patients), etc?

      Also, be sure to keep her fingernails cut very short and filed, and clean them regularly. That will help minimize infections.

  4. Debbie says:

    My mother rubs her head constantly & my New Years resolution is to leave her alone about it. I tried hats, even a pink hard hat but her hand goes up there any way & starts rubbing away. She does it with the phone when she’s talking to my sisters, looks at me when I ask her to stop & does it anyway. I just try to explain to the hair dresser when she gets her hair cut that it isn’t from an itchy scalp. I tried cortisone creams but if I’m not watching she will use a huge tube of it every day. It is driving me crazy watching her so I think that now I am the one needing medication to calm me down! I tried to redirect her hands to something to fiddle with but she will have the object in her hand & go for her scalp at the same time.

    1. AlzCarer says:

      Good luck with your resolution … ! Debbie, are you really sure it doesn’t itch? Because if it does, the poor woman may really be suffering. I know my scalp will itch like crazy if I don’t wash my hair often enough (every other day) with a shampoo designed to help itchy scalps. Try googling for “itchy scalp” to find the many things that can cause this symptom. Note also that many of the meds we give our loved ones can causing itching as a side effect. If you haven’t talked to her doctor about this problem, I’d suggest you do that — and maybe ask for a referral to a dermatologist. And you do want to make sure she doesn’t scratch herself to the point she gets an infection…

  5. Debbie says:

    I have had her to doctors & they can’t find a reason for the itching. I tried every shampoo & remedy imaginable. When she had the hats on, she rubbed so much that the hats were bloody. Out of every hour she spends about 56 minutes rubbing her head….I don’t have the strength in my own arms to leave it up there for more than 10 minutes at a time so I don’t know how she does it! I worry about it because besides infection she still has the soft spot on the front of her head that normally closes in infants. Hers never closed.

    1. AlzCarer says:

      What a mess. Have you checked out all the meds she takes, to see if they cause itching as a side effect? Skin disorders are pretty common side effects of the meds typically given to elderly dementia patients. My favorite website for looking up meds is RxList.com .

      Sometimes — not terribly often, but sometimes — our loved ones have obsessive-compulsive disorder (OCD) and may respond to a med for that, such as certain SSRIs (escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline) or the TCA clomipramine. See, e.g., the WFSBP Guidelines and the Medscape review.

      Or it may be a sign of anxiety. SSRIs are also the first line of defense against chronic anxiety, but other drugs may be helpful, too, such as lorazepam (Ativan) or oxazepam (Serax).

  6. Debbie says:

    My mother told me that it comforted her to dig in her head & that it shouldn’t bother me so I left her alone about it. She was reading books, watching game shows & talk shows on tv. Now since I stopped telling her to stop it as progressed to the point that she no longer watches tv other than a quick glance, doesn’t read at all and just sits in the chair with her head down, eyes closed, grimacing and digging away at the head…her whole waking time is focused soley on her head. I would think if it were due to medication she would be doing it all over not just at the very top strip about 4 inches long by 1 inch wide. The only time that varies is if she tries to do it on the sly if company is here, then her hand moves to the side of her head like she is trying to “rest her hand on her head” but the fingers are constantly going. I have to leave the room because I can’t stand to see it.

    1. AlzCarer says:

      Hi, Debbie. It sounds more like your mother’s scratching is associated with anxiety or agitation. It also sounds deeply-rooted enough that suggestions under “stop the scratching”, toward the end of the article, may not be enough to break the cycle … although gloves, if she’ll keep them on, and at least keeping her fingernails clipped short, may help protect her poor scalp.

      Have you talked with her doctor about the possibility of giving her an SSRI? They not only may help if there’s an OCD component to her behavior, but are also the first line treatment for chronic anxiety.

  7. Robbie McCartin says:

    I just wanted to add to this, so you had more more information. My mother is going to be 86 next month and she began scratching and picking at her head more and more as the months have gone by. I have tried giving her things to keep her hands busy, but soon her fingers are back in her hair. Her hair is clean. She says it doesn’t itch. It seems to be a symptom of this disease? I have no idea why, but my father had a different type of dementia- he had lost oxygen to his brain. He did not get this fidgety head scratching symptom. It is distressing for caregivers. I think short nails, scalp care,offering options to keep hands busy… are the best choices. I would not put restraint mitts on my mom unless she had an infection.She does do it ALL the time. Just another case to add. She takes Paxil and Aricept.

    1. AlzCarer says:

      Hi, Robbie. Thanks for your input. I’d agree that restraint mitts should only be used in extreme circumstances.

  8. Silvia Latimer says:

    Thank you so much for the advise. My mother has moderate dementia and diabetes. She scrateches her head constantly. We have eneded up at ER with infections where she scratches. WE have tried everything. Her doctor has switched her depression meds from Citalopram to paroxetine to see if it helps inhibit the urge to scratch. I feel supported knowing that many other people are experiencing teh same problem. Not that I wish this to nayone, but their cases and your advise help me reconsider what I am doing. I will certainly try a couiple of the ideas you give us. Thank you again!

  9. Dewey Bright says:

    My wife has dementia which is why I am on here. She has not yet had any of the scratching issues, but I just had a comment. What about using rubber surgical gloves for these folks. They could still scratch [sort of] but this would eliminate the infection issue. Thanks for your website; I will be checking it religiously as time goes on. My wife is 69 and was diagnosed almost 6 yrs ago.

    1. AlzCarer says:

      Excellent idea!

      I have been having back problems that limit the time I can spend on the computer, so I haven’t written much recently. I do hope to get back to it soon. Meanwhile, if you have specific questions/concerns, please let me know.

    2. Barbara Stanley says:

      Hello, Dewey. My mom did a bit of scratching too, but what she REALLY did all the time, was put EVERYTHING in her mouth. So if your wife starts doing the same, keep a very close eye on those gloves! It would be like giving a small child a deflated balloon to play with, and having them choke to death. My mother has been gone 8 years now, and I can still very vividly remember the day I was rolling her wheelchair out to her favorite spot by the pond, and she made a wild grab for the Rhododendron bush and stuffed her mouth full of those poisonous leaves! What a scare that was!

      Now that I’ve found this site, I’ll get as much info from my 3 sisters as I can (they lived much closer to the folks than I did). I’m pretty sure they found a wonderful solution for the scratching!

      Another thought…. any excessive scratching under the chest, under the belly, or between the legs, can happen VERY easily, if the family member is not dried off well after bathing, because it becomes a breeding ground for fungal issues. We used to dry mom gently with a warm blow dryer, than use CORNSTARCH in those areas. Better to prevent it before an anti-fungal cream is required. And if the loved one happens to touch, than put those fingers in their mouth, it’s safe! lol! I use this in my own personal hygiene regimen now, and honestly don’t know how I didn’t scratch myself silly without it!

  10. Pam Kollar says:

    My husband has been picking at his face, ears, neck, upper back and shoulders. When I tell him to stop he says he is just feeling his skin. There are scabs, red swollen spots all over his shoulders especially. When I show him the areas in the mirror he has no idea how his skin got like that. I have been putting bandaids ALL over the areas. I get one area healed up and another is bloody. It is nice to know I am not alone and that this can happen to people with Alzheimer’s. I will have to change the body soap and increase the application of lotions and creams. An infection is my greatest concern, but at least I now know it happens to others. He takes very few meds but I will check the side effects just to make sure it is not a medication issue. Thank for this website.

    1. AlzCarer says:

      Pam, this is such a difficult problem to deal with, sigh. Bless his heart. Well, and yours, too — I know it hurts your heart. Often, we cannot find an underlying reason for the behavior, and have to just try to minimize the damage. Keep his fingernails trimmed as short as possible. And … whenever he starts the “feeling” and picking, put something in his hands to preoccupy him — see if you can’t keep his hands busy, with an activity apron, or maybe a plush toy if he’s fairly far along in the progression (many of our loved ones take great comfort in toy animals), or something like worry beads. Or distract him with a toy or game or activity.

  11. stacey says:

    I’m taking care of a 90 year old woman now she sucking her fingers and picking her arm I put cream everyday and I give her candy when she sucks her fingers her case worker knows what else should we do.

    1. AlzCarer says:

      Hi, Stacey. Keep her fingernails trimmed very short, and have her wear long-sleeved tops (blouses, sweatshirts, robes, etc) with sleeves that are difficult to roll up. I’ve never tried a “security sleeve” such as Posey makes, but that might work. Also, do whatever you can to keep her hands busy — she may simply be bored and fidgeting. She might like to have a doll or a stuffed animal to play with, worry beads, a twisty toy such as Tangle Therapy, Playable Art-Ball, or a Rubik’s Twist (Rubik’s Snake), or a “sensory activity apron” or “activity pillow”. Google — you can find these in many places such as medical supply houses, AlzStore.com, Amazon.com, etc.

  12. Robin Lynn Wildes says:

    It is good to know that we are not alone. My 89 year old grandmother started this picking thing a few months ago. It was just around her neckline, and has now moved to her arms and her face…and her head where she had surgery a year ago. She isn’t interested in anything, and believes that her skin is DRY and that the picking is dead skim or scabs but she does it for hours at a time. We have tried creams, detergent, keeping her fingernails short…none of it works. I believe it started when we started her medicine, Donepezil, so I will have my uncle check with her doctor and maybe we can adjust the dosage. My prayers are with all of you who are going through this.

    1. AlzCarer says:

      Hi, Robin. Instead of adjusting the dosage, you could also ask the doctor about switching to one of the other cholinesterase inhibitors — Razadyne or Exelon, or even nonprescription huperzine A. A patient who develops adverse side effects from one of these drugs may do much better on another. See:

      Alzheimer’s Drugs — Fact and Fiction

  13. Dianne Golledge says:

    My 86 yr old mother who was diagnosed with early stage Alzheimers 12 months ago is a picker/scratcher too :( it has been going on for about 5 months now. Her bad areas on on the top half of each arm and as far as she can reach around her back. She will sit there and slide her left hand up the right sleeve & slide the right hand up the left sleeve and just pick. Her arms and back are scarred and bloody & look horrendous. I keep the areas covered with band aids and put surgical pads down each arm kept in place with surgical tape. It is costing a fortune in band aids etc but I find nothing else works. If I give her something to occupy herself she will fiddle with it for a bit the just put it down and go back to scratching. I had her to her general GP last week and he has sent her for blood tests suggesting that in rare cases low iron levels can cause itchiness, haven’t got the results yet but otherwise said it was now probably just habit. She is due back at her geriatrician next month so I will see what she says. While it breaks my heart to see mum like this it is somewhat comforting to know we are not the only ones going through it, thank you all for your tips.

  14. Diane D says:

    My Aunt has severe scratching. She picks until she bleeds. I notice when we are not staying with her, when we come back she has again gone up and down both arms, with making more bloody openings of her skin. Do you think Aricept, or Namenda is the cause? It seems she started this about the time she was put on these two medications. Her personal hygiene has changed, I never see her bathe, and will wear the same outfit for days. Also, with forgetting who came to visit, can’t come up with family names etc. what stage is this considered? Thank you for your help!

    1. AlzCarer says:

      Hi, Diane.

      Pruritus (itching) and urticaria (hives) are frequent side effects of Aricept. You might want to talk with her doctor about switching her to one of the other cholinesterase inhibitors, which are much less likely to cause skin problems. Razadyne (galantamine) appears best of the three prescription drugs from this particular perspective.

      Namenda is unlikely to be the culprit.

      However … I want to be sure I understand your comment about timing. Does she scratch only when you’re not around? Because if so, that doesn’t sound so much like a side effect of a drug, as it does something like picking at her skin due to anxiety or boredom.

      You may want to start keeping a daily journal of her symptoms/behaviors, as well as anything that could affect them — changes in drugs/dosages (including OTC), stresses, illnesses, storms, strange visitors, etc. This disease can be such a roller coaster that your memory of what happened when won’t be reliable all by itself.

      The best description I’ve found of the seven stages of Alzheimer’s is at:


  15. Marilyn M says:

    I find that Sarna Lotion is a good quick relief with larger areas that itch. It is made from menthol and camphor, so it is “smelly” when first put on but the remaining odor is quite pleasant. DO keep up with moisturizing and try to find the “culprit” that is instigating the itch.

    In a pinch and less costly than Sarna is Vicks Vaporub. It has menthol, camphor and eucalyptus. It is quite “aromatic”, but the smell might be soothing to the mind if it was used earlier in life with a loving hand. (My mind goes back to colds where the VIcks was plastered onto my chest, the gurgling of the steamer in my room and my parents taking turns reading to me.) Also, it is good for a muscle rub.

    Best hugs to those of you who are helping aging parents in their time of need.

    1. AlzCarer says:

      Thanks for the ideas, Marilyn.

  16. Grant says:

    Does anyone know if the itchy skin is related to, or the same as, Eczema?
    Or; are these separate conditions? Has anyone seen areas of the skin become inflamed, and red leather like?
    Thanks so much.

    1. AlzCarer says:

      Hi, Grant. Eczema is a general term for any type of dermatitis or “inflammation of the skin.” The word is sometimes used as synonymous with “atopic dermatitis”, which is an itchy, red rash that typically has its onset in childhood.


      A dementia patient might develop eczema as a side effect of a medication — it’s a fairly common reaction to Aricept, for example. If your loved one has a rash, check for side effects of his/her meds at:


      That’s the first thing I’d look into. If that doesn’t identify the culprit, it could be an allergic reaction to a new (or new formulation of) soap (laundry, skin, hair), skin cream, latex (in clothing, bandages, gloves, etc — my husband developed a nasty allergic reaction to latex bandages), fabrics (I’m allergic to wool) … almost anything your loved one comes into contact with or ingests.

      Definitely talk with a dermatologist. Skin rashes are notoriously difficult to diagnose.

      But for most of our loved ones, the skin looks normal and the reason for the apparent itching isn’t readily identifiable.

  17. Tom says:

    GABAPENTIN – In the latter stages (3+ years) of my dad’s Alzheimer’s he started itching all over and his scratching was driving both my parents nuts. Mom spent nearly two years taking him to doctors and trying all sorts of lotions, creams, soaps, detergents, fabrics, fabric softeners and no softeners but none of them helped. The first notion is to think it’s a condition in the brain and nothing is going work but somewhere along the line a creative doctor prescribed dad the anti-seizure medication Gabapentin. Within days the scratching stopped and there were never any noticeable side-effects. It was a real blessing until his last three weeks when he refuse to take pills and scratching became our least concern. (Dad was a very healthy man and Gabapentin was the only medication he was taking.) –Because of the amount of time and frustration that went into finding a remedy for dad I feel compelled to throw this option out there for whoever it may help.

    1. AlzCarer says:

      Aren’t you nice! I did a quick search of the medical literature, and neurotropic drugs such as gabapentin or pregabalin are indeed prescribed for neuropathic itch and psychogenic itch. I’ve never seen mention of them in any of the papers and articles on dementia I’ve read. I’ll have to update the blog.

      THANK YOU!!!

  18. Allison says:

    I take care of a dementia patient, not only is she messing up her skin by scratching all the time, she also Hacks from the time she opens her eyes in the morning.
    She doesn’t hack anything up, it’s just a clear salvia and there’s no stopping her.
    Sorry to say but it’s very nerve racking.
    Any suggestions?
    Thank you

    1. AlzCarer says:

      Ewww. I’ve heard of this before — in fact, it appears to be a pretty common problem — but I don’t think anyone ever found “the” solution.

      Off the top of my head:

      Try offering her chewing gum. I have seen anecdotal reports that sometimes works.

      Check the side effects of her medicines. Some, such as Aricept (donepezil) can cause excessive salivation and drooling, and/or post nasal drip. (The latter is quite common, and I could see post nasal drip triggering hawking and spitting.) My favorite website for looking up side effects etc is http://www.rxlist.com

      Perhaps talk to her doctor about arranging for a referral to a speech therapist for a swallowing test. In the later stages, various types of swallowing problems may develop, and she may not be able to swallow her saliva even if a normal amount is being produced. She may simply be holding her head too far forward to swallow easily, and physical therapy to strengthen her neck and shoulder muscles and/or something to support her head (higher backrest for her chair etc) might help. See:

      Note also the suggestions to have her dentist check for problems — inflammation, infection, maybe badly fitting dentures, something like that.

      Note also the comment about gastric reflux. Many dementia patients develop that. It can trigger mucus production. Talk with her doctor about giving her antacids to see if that might help.

      I wonder if Flonase nasal spray would work. It’s one of the few nasal sprays for congestion that can be used indefinitely (most will eventually start causing congestion), and if the problem is post nasal drip, it might loosen things up enough for the drip to stop bothering her.

      Or you might try a saline nasal spray to thin mucus and decrease postnasal drip. These are available OTC at your drug store.

      If nothing else works, ask her doctor if a med that helps dry up saliva would be at all advisable. Some drugs that are prescribed for excessive drooling, e.g., oral glycopyrrolate, are anticholinergics and are typically contraindicated for an Alzheimer’s patient. Atropine drops applied to the tongue and/or scopolamine patch are used to dry secretions in the end-stage hospice patient. Both of these are also anticholinergics, but since the method of administration is more local, they may not have such a wide-reaching effect as a systemic drug. And excessive saliva is a serious risk, in and of itself, since dementia patients who experience drooling problems are at a much higher risk of breathing saliva, food or fluids into the lungs, which can lead to gagging, coughing and possible infections (e.g., aspiration pneumonia).

      Read more : http://www.ehow.com/about_6175045_drooling-problems-associated-alzheimer_s-medication.html

      You might want to also consult an ENT specialist (ear nose throat) — they may have more tricks up their sleeves for something like this than a GP or internist.

      And if you do figure out how to help her, please let us know!

      - – – – -
      See the comment from Tom about gabapentin if nothing in the article helps with the scratching. I do believe he’s come up with a good solution. Be sure to find out what side effects might develop, so you can keep an eye out for them.her

  19. Samantha says:

    My grandmother was diagnosed with Dementia recently. She has an extreme form of paranoia in which she accuses family members, her grandchildren, of spraying her with a “special” spray that causes her to itch. She says she hears a spraying sound then begins to itching. She goes on and off with taking her medicine because she doesn’t think anything is wrong with her. At first, we thought it was all in her head, but then we began looking at her skin where she was itching, which is usually on her neck and back, and noticed little red bumps. We are unsure of what to make of this, but we do know these accusations are slowly tearing our family apart. My 12 year brother is one of the people she accuses, and I can tell she scares him a bit because when she stays at our house, she searches him and rifles through his belongings searching for that spray.

    1. AlzCarer says:

      Hi, Samantha. It’s hard to tell whether your grandmother is suffering from delusions, which is a type of psychosis that may develop in dementia patients, or is confabulating. This is not a typical delusion, and it appears there is actually a rational (in her mind) reason for her behavior.

      The little red bumps sound like hives, which is an allergic reaction. Hives can be caused by many things, including medicines, foods, even stress. (I developed stress hives. Not fun.) I’d suggest that you try to remember when her itching started and whether anything else, such as a new medicine (including over-the-counter) or a change in diet or even a new soap or laundry detergent was started just before. Make an appointment with her doctor to discuss this asap, and maybe ask for a referral to a dermatologist. Skin problems can be very tricky to diagnose and/or treat, and a specialist such as a dermatologist may be needed.

      Your poor grandmother is suffering. I suspect if you can discover what she’s allergic to and get rid of it, her accusations will go away.

      It doesn’t sound as if she is able to do important things such as remembering to take her medicines by herself any more. She may need a higher level of care now. Talk with your local chapter of the Alzheimer’s Association:

      and your Area Agency on Aging:

      to learn more about dementia, the symptoms that may develop, and the ways in which it may progress, courses you can take on how best to care for her, and also to find out what programs and services are available where you live.

      1. AlzCarer says:

        By the way … if the doctor prescribed Aricept (which they often do for dementia), pruritis (itching) is a frequent side effect.

  20. elaine says:

    My father is 91 and has suffered from dementia for around 7 years I have found a rubix cube one of the greatest helps, word search and jigsaws. However I am now up against a new demon his nose keeps bleeding, (through him messing with it continually) every time I manage to stop it 7_8 times a day plus , he blows the clot out and we start again . I have been to A&E the doctors, he has had it Corterized. All to no avail, the doctors are unable to suggest a way to stop him , do I just leave him to slowly become anemic ?

    1. AlzCarer says:

      Oh, my. Well, off the top of my head … It doesn’t sound like itching per se is the problem here, it’s probably more the sensation of having the nostril blocked. I don’t suppose you could get him to wear a disposable dust mask until it heals? Is he actually blowing his nose, or picking at the clot? For picking, you might be able to minimize the damage if you could get him to wear mittens or thick gloves. I looked at articles on what to do for frequent nosebleeds in toddlers, and found some additional ideas that might help. See: http://www.parenting.com/article/ask-dr-sears-frequent-nose-bleeds Elsewhere, a comment was made that people should avoid smoking around a child who is having frequent nosebleeds, since smoke contributes to nasal dryness and irritation.

  21. Carolena says:

    I am not alone I see, I have been so frustrated trying to get my 88 year old Mother to constantly stop rubbing areas on her head and around her mouth till they look kind of bruised after a while. I tell her daily sometimes 5 times a day to please not do that it can get raw. She says she feels something there and doesn’t want anything on her face and to leave her be. My mother was a nurse she was a strong independent women and to see the changes hurts me so much” too see her this way with all the symptoms I am seeing now, If anyone knows of any programs for a daughter who is stressed beyond belief and sometimes just needs a outlet in the Seattle/Tacoma area of WA. please let me know…Sincerely Frustrated…boniquapinky@yahoo.com

    1. AlzCarer says:

      Hi, Carolena.

      I’d suggest you contact one (or more) of the Memory Disorder Clinics in your area:

      Your local chapter of the Alzheimer’s Association:

      And your Area Agency on Aging:

      to find out what programs and services are available where you live.

  22. Bozena says:


    So my father recently fell and broke his hip, and we think he might have had the fall because of a stroke. He was mildly demented before but since the fall and becoming bed-ridden he has started exhibiting severe dementia (over the last month and half). I am contacting you because he has developed a really strange tick and we’re not sure what to do about it. He bascially clasps onto his testes until they hurt and he screams. I’ve heard of rubbing them as self-soothing behavior in demented adults, but I’ve never heard of this type of self-harm. He also has a stomach catheter so we are wary of him dislodging it while gripping his testes. Have you encountered this before and what would you recommend we do? He is 87 and, yes, we do have restraints for him, unfortunately.


    1. AlzCarer says:

      Are you sure he’s causing the pain? Or might he be holding himself there because his testicles hurt? Has he been examined for a problem there, e.g., had an ultrasound? Have you consulted a urologist?

      There are a number of things that can cause pain in the testicles — torsion of the epididymus, blood clots, cellulitis, kidney stones, epididymitis, perhaps a fungal infection like jock itch, etc. Some of these can develop into very serious problems if not treated.

      My husband gradually developed increasingly severe testicular pain. An examination by his PCP and an ultrasound didn’t turn up anything, so she suggested consulting a urologist. The first uro we tried was, to put it bluntly, an insensitive, incompetent jerk who claimed there was a nerve getting pinched and my husband would just have to learn to live with it. Fortunately, the next uro was kind and knowledgeable, questioned me in detail about what I’d observed, did a quick exam, and told me he thought the problem was caused by the scrotum dragging against the sheets when he was getting in and out of bed — that my husband was putting a little pressure on the scrotum, getting it tucked under his legs, and every time, that was causing a little trauma. The damage was cumulative, making the pain worse and worse. So (a) I was supposed to be very careful to hold the scrotum up off the bed whenever my husband was getting in or out of bed. (b) I should switch to smoother sheets. (I’d been using flannel because I thought they’d feel soft to him.) And (c) I should use a washcloth or small towel to prop up the scrotum when my husband was lying down on his back, to help minimize inflammation.

      To my amazement, these simple precautions clearly helped my husband feel much better within a couple of days. (It’s so hard to figure out what’s going on when they can’t really tell us, isn’t it?)

      The uro thought that the other likely cause was a skin infection (epididymitis). Apparently, the same bacteria that cause UTIs (urinary tract infections) can cause epididymitis. The urologist gave me a prescription for an antibiotic to try if the precautions for eliminating physical trauma didn’t work. And if that didn’t help, he recommended consulting a dermatologist, saying that “dermatologists have a hundred drugs for treating skin infections for every two or three a urologist has.” Happily, we didn’t have to do any of that.

  23. carrie says:

    I believe that items with buttons, zippers etc are available Does anyone have a design even pictures of these items? I believe some are in the shape of aprons or very thin cushions Help Please?

    1. AlzCarer says:

      Hi, Carrie. These are offered by several organizations. Google:

      Alzheimer’s activity apron

      and you should pull up quite a few different sites. If you have trouble finding them, let me know and I’ll give you some links.

      1. AlzCarer says:

        Oh — you’re in Australia. Try: https://wa.fightdementia.org.au/wa/about-dementia-and-memory-loss/resources/resources-wa/assistive-technology-product-information-sheets/sensory-and-therapeutic-intervention for patterns for various types of sensory items.

        Googling for:

        alzheimer’s activity apron australia

        will pull up local organizations that sell “sensory and hand skills” products such as:

        I’m not familiar with any of these, but perhaps your local Alzheimer’s support group can tell you more.

  24. L Clayton says:

    Mom is 87 with moderate alz. The head and skin picking and fingernail clicking is so bad at times i retreat to my room.i have found that 100mgs of gabapentin-a-prescription-is helpful and also over the counter benadryl 12.5 mgs late morning and early evening if needed really helps.

    1. AlzCarer says:

      Thank you for your comments! Anyone who comes looking for information on what might help with this problem is usually quite desperate. It’s nice to know there are meds that can help when everything else is ruled out.

  25. Janet says:

    This is the most bothered I have been by the scratching and picking of his skin by my husband. Hence I sought this site. I will look into your suggestions. He will be going to his PA next week. Interestingly. he takes 23 MG of Aricept. You have given me some hope with your suggestions. I buy very little that has fragrance in detergent, soap, etc. I must try to find a way to secure his long sleeves. He pulls up his sleeves. He says he does not itch. He pulls up the front of his shirt and tee, too. He wants to please and apologizes, but I know he can’t help it. I have been complaining to him about the behavior the last few days and I didn’t want to continue. It does not help as most of you know. Also, as an aside, he picks things other places, like the floor, or loose strings on his clothing. And he thinks he has bugs in and on him. We had his sputum tested at one point. I asked him to show me the bugs (he sometimes calls them parasites) but he does not. He hacks to bring up these “bugs” also. Enough said.

  26. Dianne says:

    My mother had a stroke in which we are now dealing with Dementia. She does not have an itching problem however, she thinks that there is something in her mouth. There is nothing there. We have been to the dentist, got a second opinion, went to the primary care Dr. and the neurologist. It has been determined that this is more of a hallucination. She is taking abilify for it. It is not working at all. She thinks that there are metal objects in her mouth and feels things wrapping around her tongue. It drives her crazy all day until her tongue feels raw. When she stops to think about it she realizes that it is not real however, she cannot stop it. Has anyone experienced this and does anyone have any suggestions?

    1. AlzCarer says:

      Whoa! I have not heard of anything quite like this, but let me think on it and get back to you. Does she have any aphasia (difficulty communicating) that might be affecting her ability to describe what is going on? Are the sensations painful, do you know? Why does she think the objects are metal? And do you know what part of the brain was damaged by the stroke?

    2. AlzCarer says:

      Having pondered your comment during the night … it just doesn’t sound like hallucinations to me. I’m not a doctor, but I did read the medical literature on hallucinations extensively for my blog on that topic. Your mother’s symptoms do share some characteristics — I can see why the neuro came to that conclusion — but hallucinations are usually transient, whereas your mother’s symptoms sound too persistent; and tactile hallucinations are pretty rare and tend to co-occur with visual hallucinations (e.g., seeing a cat that isn’t there and being able to feel it when petting it.)

      I’m wondering if it’s due to something similar to phantom limb pain — the stroke severed the normal connections between the brain and some part of her body, instead of amputation severing them, and the brain remapped that part of the body’s sensory circuitry to her mouth. 


      And if that’s true, then (a) it’s no surprise an antipsychotic isn’t helping, and (b) there are a number of different drugs that might help.


      Many of these have also been effective for pruritus (itching) and paresthesia, including formication, as well. (Note: Namenda, which is often prescribed for Alzheimer’s patients, is an NMDA receptor antagonist. It has a pretty good safety profile. I don’t know that it’s ever been used to treat something like this, however.)

      Plus, dementia patients often misinterpret sensory signals (agnosias). I’ve been reading up on this in order to update this blog. To my amazement, the medical community seems unaware that dementias, including Alzheimer’s, FTD, vascular dementias, and CJD, often cause pruritus and/or pain. Caregivers could have told them…

  27. Tammy West says:

    My 87 year old mother was recently diagnosed with dementia and is taking medication to help slow the progression. She keeps thinking her tongue is peeling and it looks normal except slightly red. She’s constantly putting her fingers on her tongue to remove something but there’s nothing there. I plan on discussing with her doctor.

    1. AlzCarer says:

      Tammy, I am pulling together some info for you. It’s complicated and taking more time than I’d hoped. I’ll email as well as post here when I’m finished.

  28. Sandy says:

    My 82 year old mother was experiencing extreme itching. Lotions, Benadryl, cortisone cream…nothing helped. Then, she fainted and fell and broke her arm. At the E.R. they looked into why she fainted–and it was a really bad urinary tract infection. Once it was treated, the itching went away. Turns out infection in the elderly doesn’t always present symptoms in the same way as in younger people, and itching is not an uncommon symptom. So please, if your elderly loved one has an itch that just won’t quit, look into other causes such as a UTI.

    1. AlzCarer says:

      Excellent reminder. UTIs can cause all sorts of symptoms, and we rarely remember to check for them when new symptoms flare up. Thank you!

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