Ambulatory resident with dementia who spits all the time

[karenlhm]

In LT facility, we have a very ambulatory resident who spits constantly--infection risk-- and housekeeping is going nuts. Have ruled out respiratory illness. Have tried scopolomine patch. Any suggestions?

[EricJRN, MSN, RN]

How is his mouth care? Not trying to insult anyone's intelligence, but it's often overlooked and might be contributing.

[Morguein]

What to you think about having the patient wear a face mask?

[bethem]

What to you think about having the patient wear a face mask?

If he has dementia, won't he just pull it off? heck, I'd pull off a mask if I was made to wear it all day against my will. I have no real suggestions except for educating him and re-educating him. Maybe tell him that if he needs to spit he can spit in a paper cup you give him to carry around, the toilet or a sink if he rinses it afterwards?

[weetziebat]

Good luck! We had a patient like that and there was absolutely nothing we came up with that worked. He not only spit, but then smeared it all over walls, tables, or anything else handy. Was pretty gross, even though we knew it wasnt' a purposeful attempt to make us upchuck our lunch.

[CrunchRN, ADN, RN]

I believe these types of behaviors can be helped by psych meds and have seen several articles about this in the past. Would the MD and family be open to this suggestion?

[vloho]

maybe some gum

[Marylou1102]

or mints?

[CoffeeRTC, BSN, RN]

If you don't already...get a good infection control cp ready for this guy.

A few years back I took care of a man like this. He didn't walk freely, but in his good days he got around in a merry walker. Oh...he had a few other agressive behaviors that would worsen when he would be redirected about his spitting.

When his walker was parked, we had it on a rubber mat that was easier to clean than the carpet. We would place trash cans near by, offer fluids frequently or those mint breath sprays, check with a dentist (He would never let us really do good dental care), of course check the psyche meds. Keep klenex close (if he is able to spit in them)

Pretty much all we could do was clean up after this resident.

good luck.

[CrunchRN, ADN, RN]

Medications can stop this behavior - if you give him gum or a mint you will probably have THAT spit at you!

[snowfreeze, BSN, RN]

medicate and redirect..dementia behaviors are unique to that crowd. Most of these people would not want to be remembered for spitting on walls when they are gone from us. Educating families is important. Do they want dad happy or do they want dad angry and spitting and hitting?

[luvmy2angels]

Gum is worth a try, we used it for one of our residents who also had demntia and it stopped almost immediately. I would try non-pharm options first before going right to meds, never know what side effects may come from the meds, esp. psych meds. If no other options work THEN I would discuss meds. Good luck, I know how frustrating this can be!!