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tweetzer · 07-30-2012, 04:31 PM

First post here... very good forum...

Have been caregiver and health surrogate for 3 elderly family members with Alz/Dementia over the past dozen or so years. Lots of experience with all sorts of aspects of the disease, but this is a new one...

My elderly cousin is in nearby nursing home with advanced MS and dementia. Recently she has developed a habit of chewing on her clothing and blankets.

She pulls her shirt or blanket up to her face and contentedly chews away at it, off and on all day, every day.

I have been back and forth with the nursing home staff about this because, while it may just be a 'part of the disease', my cousin is also apparently swallowing the fabric she is chewing on...

I asked them to try placing something on her chest like a cloth napkin or bib to keep her from chewing her clothing. They refused - said it was a 'dignity issue' and they could not put a bib on her.

I noted that it seemed much less diginified for her to be going around in public at the nursing home with big chunks chewed out of the front of her shirts. She was chewing her shirts almost to the point of 'exposing' her chest...

Trying to figure out what to do, I ordered XL cotton bandanas, folded them into triangles and attached velcro squares to the ends, so they could be placed around her neck like a scarf. The thinking was that she would chew the bandanas instead of destroying her shirts - and the nursing home would accept them as scarves, not bibs...

They asked her psychiatrist about adjusting her meds, which he did - but after 6 weeks has not made any difference. I prefer her to be on as little psych meds as possible anyway...

Does anyone have experience with this fabric-chewing habit? I am still concerned about the health effects of her swallowing this fabric on a daily basis. The nursing home has no comment about that.

I have asked for it to be addressed by her doctor...

Can our digestive systems can handle cotton...?

Gabriel · 07-30-2012, 05:34 PM

Welcome to the forum. It is great to have you and all your experience here. Glad you decided to post...

As you, I have years of experience and this is new for me!! I do know that they typically will put items in their mouth as a child will, and there is one in mom's unit that will occasionally chew on clothing, but it is not something that happens on a regular basis. I am trying to put myself in your cousin's mind frame and figure out what pleasure she is receiving from this activity... but unsuccessfully at this point

It has to be comforting to her of filling a need that she has. I wonder if she was an avid gum chewer, or similar habit, before dementia. I have connected Mom's constant pulling on the edges of material to her love of sewing. She's finger pressing seams!

I am also debating a number of ideas as to how to deter this behavior... but not coming up with a sure fire idea yet!! I wonder if making the clothes impossible to get to her mouth, would only frustrate her. I wonder what would substitute but would not be toxic and not be as easily to destroy. I wonder if fruit roll ups would give her the same pleasure.

I have had the same question about "dignity". Trying to maintain a standard that fits the cognitively normal individual is not always the best management of demented symptoms. I feel that giving them what they NEED, not what we are normal thinking individuals need, is a better option. Mom's facility will tuck her napkin in her neck line during meals but not use a bib. (what's the difference?) My big bottle is with utensils. Mom had NO idea what to do with all the utensils they put at her place setting. She spends more time playing with the utensils than eating. If I am there and take everything away but one utensil... she eats better. So what is dignity... having three utensils or letting her eat without confusion? In my opinion, we have to throw out our set patters to accommodate their inabilities.

I don't blame you for wanting your cousin to be on as little psych meds as possible and I truly don't believe they need to be medication for anything other than distress that makes them uncomfortable... not for behavior that is inconsequential but we find bizarre.

I would ask the doctor if there was a health problem with her eating material. I would watch her BM and be sure they are regular and there is no problem there. If the doctor doesn't see a problem and it doesn't affect her digestion... I say let her enjoy.

Love, deb

tweetzer · 07-30-2012, 07:32 PM

Gabriel - Thank you so much for your very kind reply!

I have been thinking very hard about this for the past few months since my cousin started the behaviour last April...

I observed my own mother (passed, with Alz) making chewing motions after she could no longer speak, and thought she was probably trying to tell me something...

She also would fold cloth and try to make everything neat and tidy, as she always did before... (miss Ma so much).

My cousin's mother (passed, with Alz) would bring her hand up to her mouth repeatedly, like she used to do when she smoked (her whole adult life into her 80s). (miss Aunty so much too). Other relatives have had their habits as well...

My cousin also smoked her whole life and it occured to me that the chewing might be a throw-back to that comfort-habit. She received a nicotine patch when she went into nursing home a few years ago, but maybe this smoking memory is coming back to her... ?

I was talking to my husband about this again tonight and he suggested that maybe they could try the nicotine patch again - hmmm interesting thought.

I don't have a problem with her chewing for comfort - I agree 'let her enjoy'! Except for the health issue and trying to find a way to keep her clothing somewhat intact...

I asked them about her BMs, and there is apparently no problem so far. But I hope to get a chance to talk to the doctor about it. Nursing home makes things complicated sometimes, but they are taking very good care of her otherwise - she is in a good place...

I agree with you about the nursing home dignity issues not conforming to the reality of the person with dementia - very frustrating... So good that your mother has you watching out for her...

Gabriel · 07-31-2012, 09:26 AM

You have been through a lot with your family... as have I. Mom cared for my grandmother with Alzheimer's, I worked in a care facility, my Dad spent 13 years with Vascular Dementia, and Mom is in year 6 of Alzheimer's diagnosis. Not to mention the many other extended family members with some form of dementia. I am always envious of those that don't have a clue what this disease is about

As for the habit of smoking.... my Dad stopped smoking for a long time and then his memory went back to the smoking. I do not think it was the chemical habit as much as the physical aspect of just having a smoke. Right or wrong, I would take him to the porch and let him light up on occasion. His verbal skills and reasoning were such that he could ask. He was always so cute and happy on that porch that I could not deny him that one request. Now Mom would not have been happy if she had known but her Alzheimer's prevent that from being a problem!

Talk to the doctor about the dangers of fabric ingesting. Try to figure out just how much she is actually ingesting. And keep a watch on the BM. I like the bandana idea. Be sure whatever you get is natural fibers with minimal dyes and chemicals.... or just stick with cheap white cotton t-shirts!! If it does no harm it is a small price to pay for contentment

I agree with your facility assessment. There are things I balk about with Mom's facility but for the most part she gets good care. I do realize that it is very difficult to understand the mind of the demented and that is what it takes to truly care for them on their level. You have to connect with the patient and what is best for that individual because they are all different. That balance of appearance and patient well being is sometimes hard to accomplish. Mom's dining room does look good before meals!

Love, deb

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