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The Need for Stimulation

Yesterday I was asked about a person living with dementia who scratches himself until his skin bleeds. “Is this normal for people living with dementia?” Again – I am very hesitant to ascribe ANY behavioural pattern to someone living with dementia as if it is a normal part of the disease. Scratching your own skin until it bleeds cannot be comfortable, and must be caused by itching or another underlying irritation.

The skin produces natural oils that are often depleted by a diet that is not nutritionally balanced. A high intake of Omegas (fatty fish like pilchards, salmon, sardines, and mackerel) or a supplement might be needed to maintain good skin quality. Getting out into the sun every day is essential for Vit D – it maintains good skin quality but also improves mood (essential for people living with dementia who are very prone to depression.)

Ordinary soap washes away the protective oily layer of the skin, which is not replenished by putting on body cream. Stop using soap and wash with a nonperfumed cream. (Aqueous cream). Adding essential oils to the cream will be an added benefit – Lavender, Ylang-ylang, pomegranate oil etc will be soothing to the nerves and the skin.

Iatrogenic disorders (negative side effects of well-intended medical and nursing interventions) often cause skin irritations – dry itchy skin, a dry mouth, a bad taste in the mouth, anxiety etc etc etc. Make sure that the itching is not caused by medication side effects.

Lastly – a lack of stimulation. I have often seen people living with dementia becoming so withdrawn and lonely that they would start scratching themselves, develop a twitch or pace up and down. A lack of stimulation could result in self-harm as a form of stimulation. I have also seen people living with dementia scratching in their own faeces – it is not because they are demented! It could be a desperate need for sensory stimulation. This is hard to believe, I know. But when your world is so small and there is nothing that fills the need to be loved and held and stimulated, you will desperately do anything to feel that you are still alive.

I do not believe that people living with dementia should be treated like children in a creche with non-stop activities. However, when your ability to connect with the outside world is so compromised, we need to be mindful of providing sensory AND sensual stimulation. Beautiful sights and sounds and smells and loving tactile stimulation become essential ingredients of wellness.

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