Patient Picking At Clothing/Bed Linens

Specialties Home Health Nursing Q/A

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 O2 Sat and everything else on her exam was OK.

She was resting on her bed, but opened her eyes and talked to me and answered appropriately when I spoke to her. The only thing different was that she seemed distracted (for lack of better term), and kept moving her hands around like she was picking at her clothing and the bed linens.

When I called her daughter to update on mom's condition, the daughter mentioned that patient had been talking about having seen her brother.....the patient's brother that passed away 30 years ago. I didn't say it to the daughter, but know that shortly before death, many people see and speak to loved ones that have already died.

Thoughts? Is this picking behavior unusual? Wasn't even sure how to chart it, what would you say?

Specializes in L&D.

Does she have Alzheimers or any sort of dementia? I've seen it when a person with dementia didn't recognize what was on them (the shirt, linens) and kept picking at it. And there are some psychiatric issues where people will misinterpret what they are seeing, so could be that too....Could be a host of things really! I would just chart it as "Picking at clothing and linen continuously" I think.

84RN said:
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 O2 Sat and everything else on her exam was ok.

She was resting on her bed, but opened her eyes and talked to me and answered appropriately when I spoke to her. The only thing different was that she seemed distracted (for lack of better term), and kept moving her hands around like she was picking at her clothing and the bed linens.

When I called her daughter to update on mom's condition, the daughter mentioned that patient had been talking about having seen her brother.....the patient's brother that passed away 30 years ago. I didn't say it to the daughter, but know that shortly before death, many people see and speak to loved ones that have already died.

Thoughts? Is this picking behavior unusual? Wasn't even sure how to chart it, what would you say?

This patient does have some dementia, but this is the first time I've ever seen this behavior, and I've had her as a patient on and off for almost a year now.

She's definitely declined in the last month, and has been hospitalized several times for different problems.

I've seen this mostly in dementia patients.

Specializes in ICU.

I see this all the time in delirious pts. Just can't keep those johnnies on them!!

Specializes in retired LTC.

To loriangel - I've seen this behavior many of times with the dementia pts, but never associated it as a S&S. Am always learning something new here. TY

Alzheimers you see this, and is the patient on a med that a dyskenisia is a side effect? That can happen with a number of medications. Which if the patient needs the med, a cogentin or benedryl can sometimes help. NOT giving medical advice, for learning purposes only. Research her meds.

Specializes in Pedi.

I've seen it once... the patient was delirious in acute ETOH withdrawal.

?magnesium def?

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.

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.

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.

Specializes in Orthopedic, LTC, STR, Med-Surg, Tele.

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.

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