Patient Picking at clothing/bed linens

  1. 0
    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?
  2. 31 Comments so far...

  3. 0
    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.

    Quote from 84RN
    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?
  4. 3
    I have heard "picking" described as a archtypical end-of-life behavior and have seen it on occasion in pts that were getting close (ie-weeks to days).
    Last edit by Chaya on Dec 10, '12 : Reason: sp
    merlee, MedChica, and Esme12 like this.
  5. 4
    Yes I have seen the picking motion in patients with dmentia, most often Lewy Body.They will also make a motion that is like picking threads off of things.
    jokpa, redhead_NURSE98!, nrsang97, and 1 other like this.
  6. 0
    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.
  7. 6
    The picking will be part of the decline.
    jokpa, MedChica, nrsang97, and 3 others like this.
  8. 2
    I've seen this mostly in dementia patients.
    nrsang97 and sharonp30 like this.
  9. 0
    I see this all the time in delirious pts. Just can't keep those johnnies on them!!
  10. 0
    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
  11. 1
    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.
    Orange Tree likes this.


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