Patient Picking at clothing/bed linens - pg.2 | allnurses

Patient Picking at clothing/bed linens - page 2

Has anyone ever seen this? I work in home health and have a patient with multiple serious health conditions. During a visit the other day, she seemed normal clinically---all VS normal for her, her... Read More

  1. Visit  Anna Flaxis profile page
    1
    Agitated patients with dementia or delirium will pull at clothes, bed linens, IV lines, and tubes. I've seen this more times than I care to think about.

    For a patient who is alert, basically oriented, not in acute distress, I have seen this in varying degrees, from simply picking at clothing or bed linens, to picking at their own skin, creating non-healing ulcers

    In both instances, I associate this type of behavior with anxiety or discomfort.
    Last edit by Anna Flaxis on Dec 11, '12
    MedChica likes this.
  2. Visit  sharonp30 profile page
    0
    My father in law had brain cancer. In the end, he would sit in a chair and start moving his hands as if he were wrapping string around his hands. It was really amazing to watch. He did this for about a week or two before he passed away.
  3. Visit  netglow profile page
    2
    All the above, as well as: drug reaction to heavy narcs, or, in pain/discomfort and unable to verbalize that they are in pain/has something causing pain not needing narcs but needing IV site check, repositioning, etc. unable to verbalize.
    MedChica and NurseOnAMotorcycle like this.
  4. Visit  CT Pixie profile page
    0
    Many of my Alzheimer's and dementia pts 'pick' as if they are picking lint off something. I've also seen it in pts who's health declined and they were heading for the "Celestial Discharge" and right before some of my patients started actively dying.
  5. Visit  WeepingAngel profile page
    0
    I've seen it a couple of times - once in an old lady I gave Flexeril to, and an older male patient who got Ativan. They were 'plucking' at midair in their sleep.
  6. Visit  Bouncyball profile page
    1
    I'm still a nursing student, but just had my death and dying and hospice lecture. Our instructor said that she frequently sees patients near death start picking at the sheets, clothes, or themselves. She said once pts start seeing dead relatives it is a sign of impending death.
    sharonp30 likes this.
  7. Visit  proud nurse profile page
    1
    I worked for 6 years in LTC on an Alzheimer/dementia unit. I'm pretty sure it's called floccillation...might be wrong. Seen it many times, especially working the night shift. And usually in the patient in the dying stages.
    echoRNC711 likes this.
  8. Visit  Altra profile page
    1
    Agree with what's been said above: check for hypoxia, anxiety, pain ... or if the patient is simply *getting on the Jesus bus*.
    Anna Flaxis likes this.
  9. Visit  LiveandLearn88 profile page
    0
    I've only worked with a few residents who were actively dying but all of them had the "picking" symptom, they would pick at things on their clothing, their skin, even my skin when I held their hands and whatnot. It wasn't always immediate to their passing, one of my residents started this a few months ago and just passed a couple nights ago (). Very weird.
  10. Visit  NursieNurseLPN profile page
    1
    My father started doing this when his kidneys were failing. It would get worse when he was getting dialysis and/or if he had electrolyte imbalances.
    Wise Woman RN likes this.
  11. Visit  JGMSN profile page
    1
    As a former certified hospice and palliative nurse, this "picking" behavior (the official term is carphologia) is commonly seen in delirious patients near the end of life. Based on this patient's condition, plus talking with people who have been long dead, this may be just a sign of impending death.
    KeyMaster likes this.
  12. Visit  Anna Flaxis profile page
    2
    I found these:

    floccillation
    /floc-cil-la-tion/ (flok″sĭ-lashun) the aimless picking at bedclothes by a patient with delirium, dementia, fever, or exhaustion.
    Dorland's Medical Dictionary for Health Consumers. 2007 by Saunders, an imprint of Elsevier, Inc. All rights reserved.

    carphology

    (kăr-fō-lō′jē-ă)
    [Pronunciation]
    (-fŏl′ō-jē)
    [Gr. karphos, dry twig, + legein, to pluck]

    Involuntary picking at bedclothes, seen esp. in febrile delirium.

    SYN: floccillation
    AnonRNC and KeyMaster like this.
  13. Visit  jeannepaul profile page
    1
    We see it all the time in Hospice, sometimes they will just put their hands in the air, pretend they are eating something, or other things with the hands. Also talking to and about people who have already passed, and about 95% of the pt's, if they can communicate will see little children, regardless of the diagnosis, they will talk about children, babies. It is not scary to them, but they all seem to see the same thing.

    A long time ago they used to say it was caused by lack of oxygen, but when they checked, the 02 sats are fine. Some say it's because of the narcotics, but I see the same thing with people who are not taking any medication.

    People with dementia can "pick" for years, but when combined with other symptoms, we can tell when it is getting to the end of their life. It may be time for a hospice consult.
    IowaKaren likes this.

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