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My mom has been obsessing over her nails. She files them every day, several times, and buffs them for 20 minutes at a time. It is driving me crazy!!! When it's not her nails, she seems to find something else to obsess over. Her hair is thinning, and she's obsessing over that as well. We tried Rogaine and several different shampoos. The doctor said that it's not due to medication, checked her thyroid again, and thinks it just aging.

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OCD with repetitive behavior is not necessarily associated with dementia. It is a separate psychiatric disorder. Check the 2013 PDR. The Merck Manual does not address dementia either under OCD . Check with an MD, other than the one you have.. They'll probably want to examine her.
friendofnature: Isn't it a shame that your mother, now confined to a wheelchair,
does nothing for herself?.......a waste of her final years.
How 'bout magazines? Picture books?, sewing?, jewelry making? You didn't say how old she is. Hopefully, there's TV where she is.
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Mom has dementia and has gone through several series of repetitive behaviors. She used to file her fingernails into a sharp point! Don't know where she got that one, but it passed. Then she tied and retied her shoes constantly. It scared me when she did it in the car, leaning down while I was driving. She would constantly wipe her nose (yes it was dripping some). That drove me nuts when she did it all the time in the car - I'd have to hold my right hand by my eyes to block the sight of her doing that but still allow me to see to drive. At home, she'd pile up the partly used Kleenexes on the arm of her easy chair. She'd get a stack about 1" - 2" high. She'd let her dog out constantly, but I looked at that as beneficial since it was her only exercise. He seemed to enjoy the gig, too. None of these behaviors were harmful, just somewhat annoying.

So now she's in a memory care home and sits complacently in her wheel chair with her hands folded in her lap. I'm guessing that now she's stimulated without having to make her own activity.
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OCD can occur at any age. My son developed it at age six with compulsive hand washing. With treatment he has been able to function in adulthood. Repetition and memory loss appear to be pretty constant in AL although this is not my area of expertize.
My comment concerns the use of Ativan in the elderly. It is widely used for anxiety in hospice patients young and old. The dose is usually very small to start and gradually increased if the response is positive and more is needed . If the agitation increases which sometimes it does another medication is tried. Elderly people do tend to metabolize medications slower than the younger population so caution with dosage needs to be exercised. The worst effects of Ativan can lead to coma and death. Also with any new medication the drug interactions need to be checked before giving a dose this also includes herbal remedies too. On another track inserting a catheter is pretty pointless and in my view assault if the patient refuses. She will just pull it out anyway, this happens all the time. It must be remembered that no drug is 100% safe for 100% of the population but the risk is usually worth the result. Who wants to die in pain when medications are available even if in an addictive class. Some people require unbelievable amounts of narcotics at the end of life but hospice is not described as comfort care for nothing
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Thank you all for your insight. I really appreciate it!
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I'm not sure the specifics of the disease, all I can do is identify with you. My grandfather died of dementia and alzheimers and he demonstrated very repetitive behaviors for a few years before he died. I believe when people get older the things they worry and obsess about during their life become magnified as the mind goes and those things become more of a concern than ever. With my grandpa he had four outside doors on the house, ceiling fans and furnace issues, turning things off at night out of home protection. When the alzheimers and dementia set in, he would make the rounds at night locking and turning off, but he would do it 15 times before he was convinced it was safe to go to bed.
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Bags. Plastic grocery bags. I moved Dad out of his house and found bags and bags of bags with lots of bags.
Keys. I once had to Fed Ex him a key to his car. Now I found at least 10 duplicate keys to that car around the house.
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@hacken7902 I read your post about the trash obsession and had to chuckle. That was one of the ocd behaviors that my husband did. He couldn't even wait for the grandchildren to eat all of their fruit cups and sometimes dumped the remaining fruit out on the table so he could walk to the outside trash can. If there was "trash" in the car, he would throw it out the window. He did this to a book, a camera, bills to be mailed, a bill of sale for an ATV and a garage control. I would have to circle around to try to find it again, hopefully in one piece. He would meet the mail lady out by the mail box. He would then promptly put it all in the trash can. On Fridays, trash day, I had to be sure to race out to the curb to retrieve any important mail before it was gone forever. Several bills didn't get paid on time and a couple of pay checks had to be replaced when I didn't quite get out there in time. LOL
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Thank you all for your insight. It helps to know I'm not alone.
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My father who is in the end stages of Mixed/Vascular Dementia started repeating himself over five years ago. He talked constantly, but it was all repetitious. About three years ago he started with routines that he had to do continually. If you distracted him, he would become angry and agitated. Once you backed off, he would start his routine. He talks a lot, but doesn't comprehend anything anyone says to him. He is impossible to redirect. I think they get stuck in their own world. Maybe, it is comforting to them. They feel safe in their own routine so any disruption causes them anxiety. I am no doctor, but I think it is the way the disease effects different people and different parts of the brain. It is extremely difficult to be around for any length of time.
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My husband had Alzheimer's and he didn't do that and his aunt didn't. Could be her medication. Doctors over due on meds. That's a known fact
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"My father has limited brain processing capacity, but a need to use it. So he is constantly obsessing over something."

That describes it so well, BlueRidge.
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I guess clinically it's not OCD. My father has limited brain processing capacity, but a need to use it. So he is constantly obsessing over something. It lasts a few days and then it's replaced by something else. There's always an emergency, always a problem, always something he's upset about. This won't kill him, but it might kill me.
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OCD - my husband has early Alzheimer's and is obsessed with garbage. Even when the trash is out to be picked up, if you so much as put a paper napkin or tea bag in the clean inside trash he will pick up the items with his hand and run them out to the trash can. Even a 1-1/2" post-it note starts trouble. Then he complains he has to go out AGAIN to the trash can. I started hiding any little bits of trash now - solves the problem.
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@Jinx4740 - I'm tending to agree with both you & @Athena3 - I took Melantonin twice .05 mg NEVER again - gave me horribly vivid dreams - ugh - woke up every 15 min or so! And yet they still suggest it as a sleep aid - YES your body MAKES melantonin, BUT when you take anything as a supplement it can cause side effects - everyone'd different AND you have to know your own body & how it usually feels.
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Hi, krusso...I can't actually tell you why there are risks for the elderly with dementia when given Ativan, I just know that there are definitely risks...my Mom wasn't given Ativan by Hospice, she was given it in the ER...she ended up with Hospice, however, because of what happened after getting the drug. I guess all drugs can cause damage to some people, while they can also greatly benefit others. However, because of what happened in my own family and also with the information I've read from the website I mentioned in my previous post, I just don't think it's worth taking the chance...
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Not as a medical person, but as a connoisseur of antidepressant medication, I know that a medication that works fine for 90% of everyone can really be bad for the other 10%. So I think it's not always bad to give Ativan to the elderly, but that they should be looking out for any sign of a bad reaction.

My experience with antidepressants is that Prozac upset my stomach but Zoloft was fine. My friend Jane found that Zoloft gave her diarrhea, but Prozac was fine.

I have used Ativan, and it is very gentle to me, but I know that I would be super careful if giving it to someone with liver or kidney problems, because they can't get it out of their system that easily. I also know that, even if the dose is small, I got some weird effects when I stopped cold turkey. I just took a half dose every other day for a few days, and then I stopped with no problem.
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I'm a Hospice volunteer & they give Ativan to patients all the time @Athena3 what are the risks associated w/Ativan? I enter volunteer/grief notes so I'm not in the nursing field, although I AM a Certified Medical Assitant - just wouldlike to know the side effects of Ativan & WHY does Hospice give that to the patients?
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I am not a doctor and cannot say one way or the other if it is part of Dementia or not.
However, my mother did repeat herself for many years before she passed, It increased little by little and by the time she was in assisted living then nursing she was making all sorts of claims and repeatedly told me the same thing (about 20 times every 5 minutes) and didn't remember that she had told me. When she started getting irritated with me for saying that she already told me that , i would just nod my head or say ok, It's irritating but a minor thing to deal with considering what they are mentally going through. My mom must have told me a thousand or two times that she lost a tooth, someone punched her in the face, the woman in the next room had a baby and killed it, there were bugs biting her in her bed every night, the staff was having sex in a bathtub every night. AND that she had been raped (which when i requested that only a female help her undress at bedtime they had to report her claim to the state even though I told them that it was just a fantasy) OMG! Had to fill out a formal questionnaire about that claim for the state.........These claims continued increasingly until she passed. They got more elaborate and after awhile she talked about nothing else, repeatedly (AND I MEAN REPEATEDLY) I feel that it may have something to do with the brain gradually diminishing from the decease and the repeating is not recognized as such ....The repetition is somehow comforting to them. I'm sure that the physical repetition is somewhat the same. Smile, Grin and Bare it -----And just be glad that this is a harmless activity. ps The psych did put my mom on anti psychotics =but they did not seem to help-------Good luck I'll keep you in my prayers
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Many people have OCD, it's not part of Alzheimer's.
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While I don't really know the true answer to your question, I do want to tell everyone here to please be very, very careful when trying to treat the anxiety issue...do not give an elderly dementia patient the medication Ativan...I have first-hand experience with the damage it can cause...my Mom had a 'resolved TIA', but was given Ativan for her 'anxiety'...she was admittedly given ' a lot', because the nurses were trying to insert a catheter that my Mom didn't want...my Mom never recovered and died one week to the day later. An aunt of mine passed away under somewhat different conditions, but from the same medication and in almost the same way...she just never came out of it. I don't want to scare anyone, but please, please be very careful. You can google 'Ativan and the elderly' to read more stories about this drug. Best of luck to everyone who is dealing with this situation...
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This might be something that is comforting for her and that she can "still do skill fully and have the attention span for". Many other things in her life might be too hard, or overwhelming and this brings her comfort.

If it does and she isn't damaging her nails, bleeding, etc.; i'd let it go and tell her how beautiful they look. If she starts, maybe you want to re-direct her to another activity or doing something together that you both enjoy like a craft, looking through pictures, folding laundry or something.

If you are really concerned about the behavior, you could call the dr and ask if there is something he can give her that is low dose anti-anxiety. That might help.

My mom is obsessive because she knows she is "losing her mind" so she becomes obsessive with bills, wallet, purse, -- checking and rechecking to make sure everything is in order. This can repeat several times a day.

I offer reassurance and let her handle/pickup and put back the bills, letters, etc. as she "needs to do this" to make sure it is as she left it.
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Let's distinguish between OCD behaviors and the disease OCD. I think behavior that look like OCD can be the result of loss of memory, and the fear that comes from the loss of control and power over one's life.

Doing the same thing over and over again is a way to be calm and a way to control your failing brain. My husband washes the catfood dishes under running water for 5 minutes each. I have decided that it calms him, so I try not to fret about wasting water.

If the behavior is not harmful, try to ignore it. If it's "just" driving you crazy, try to distract her into some different activity.

If she wants to do it NOW, that's because she knows she will forget what it is if she has to wait. If she does it over and over again, it may be that she has forgotten that she just did it.

I've never heard of a link between actual OCD and dementia risk, but it makes sense. Any type of mental illness must burn out brain circuits much faster than normal.
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Find a new doctor for your mom. Although OCD COULD be a sign of AD, not necessarily! However, somethng is definately going on & her doctor should NOT be blowing it off "due to "just aging." FIND a new doctor!
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@JennyM - Mom was not OCD earlier in life. This is something that I've noticed in the past year or so. Nevertheless, that's an interesting fact!
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Everyone who I've known who was OCD all their lives has developed dementia as they have aged -- in fact, all have developed vascular dementia at a relatively early age. Don't know if this is a collateral event, a causative event, or just some anomaly because of the relatively small sample size.
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My instinct about OCD is that it stems from anxiety about not being able to control the larger picture in one's life. There's fear involved. So people obsess about things they CAN control. I think calming her down is the right approach, and doing your nails with her to give her validation and love is a great idea. Maybe she is trying to look her best. Maybe this is an expression that she needs more TLC. How about treating her to a facial and makeup and a new outfit? and have a special day out? ....
By the way, my mom has been OCD her whole life, and she was brilliant. So I don't think it's about dementia.
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I file my nails all the time when I have anxiety..My mother of 81 always files her nails too... Your mom may be nervous or have anxiety...I do believe it could be link also to ocd as well....Hope this helped..Hang in there..
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M Mom, who has Alzheimer's seems to have that sort of behavior as Well. She has become obsessive about doing things right now. If she decides she wants to go somewhere, i's right now! It doesn't matter to her that no one is available to accommodate her at that moment, she just insists and will pace the house and get angry. So I do believe OCD is part of the illness. Good luck with your
problem.
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I am not a doctor but from what I have observed about my mom with Alzheimer's is some OCD behaviors that did not exist before. As an example, she has decided to use a cake plate on a pedestal for fruit even though the fruit rolls off and bruises. I have tried replacing it with a bowl but she will hunt for the cake plate and put it back. Bruised fruit is no big deal and most of my mom's new OCD behaviors may be annoying but are harmless. If the behavior is harmful I would contact her doctor, otherwise I just take a deep breath and try to relax.
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Thank God that all she is obsessing about is her nails and hair. Yes, OCD activities are very much a part of many types of dementia. My husband started with repeating a phrase over and over again to himself. That changed to having to walk through A & F in the mall everyday in a particular pattern, then to peeing in unusual places (outdoors, in the dining room, next to our bed), then to shoplifting M&Ms. At one point he would eat only cheese, bacon, fries with a ton of ketchup, peanuts, and drink only Diet Coke or coffee. As one OCD compulsion faded, it was replaced with another. This went on for about 5 years.
Good luck with her behavior. You can check with her doctor for meds that might help. We had to stop all dementia drugs and start an anti-anxiety med.
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