For many families and carers, witnessing loved ones with dementia display unfamiliar or even challenging behaviours can be distressing. One such behaviour, which is often overlooked in discussions about dementia, is nose picking. Though it may seem like a minor issue, for those dealing with dementia patients, understanding the underlying causes and implications of such behaviours can be crucial for providing effective care.
The act itself might not be harmful, but it can be indicative of deeper cognitive changes or discomforts the patient is experiencing. Moreover, it’s essential to differentiate between occasional nose picking and compulsive, repetitive behaviours that may require medical attention. Addressing these behaviours with empathy and knowledge ensures that the individual with dementia feels respected and understood. Caregivers should remember that every action, even something as simple as nose picking, can be a window into the world of someone living with dementia.
The neuroscience behind the behaviour
Changes in behaviour, including nose picking, can stem from the progression of dementia affecting the brain. As dementia progresses, the brain undergoes significant changes, leading to damage in certain areas that regulate social norms and self-awareness. This can result in a person with dementia forgetting societal conventions, leading them to pick their nose without realising it’s not socially acceptable.
Additionally, the frontotemporal region of the brain, which is often impacted by certain types of dementia, plays a crucial role in controlling impulsive behaviours. Damage to this region can lead to various behavioural changes, including an increased tendency to pick one’s nose.
Physical causes and considerations
There can also be physical reasons for nose picking in dementia patients. For instance, a 2010 study suggested that nasal obstructions, allergies, or infections can lead to an increased need to clear the nasal passages. Dementia patients might not be able to communicate their discomfort or may not recognise it, leading to frequent nose picking as a way to find relief.
It’s also worth noting that as the sense of smell diminishes with the progression of dementia, patients may be less aware of potential irritants or changes in their nasal environment. Dry indoor air, especially in care facilities, can exacerbate nasal dryness, increasing the urge to pick.
Maintaining optimal room humidity and ensuring regular nasal care can be beneficial in reducing such behaviours. Addressing these physical discomforts proactively can significantly enhance the overall well-being of the individual.
Emotional and psychological factors
Emotional and psychological factors can also contribute to this behaviour. People with dementia often experience heightened anxiety, agitation, or even boredom. Nose picking, in some cases, can be a self-soothing mechanism, much like how some people might fidget with their hands when nervous.
A lack of stimulation or engagement can lead to repetitive behaviours. Ensuring that those with dementia have engaging activities and regular social interactions can help reduce the occurrence of such behaviours.
As dementia progresses, familiar surroundings and routines become increasingly essential to provide comfort and stability. Activities tailored to the individual’s interests and capabilities can serve as therapeutic interventions, reducing feelings of isolation and restlessness. Personalised music playlists, art therapy, or even simple tasks like folding laundry can offer both cognitive stimulation and a sense of purpose. By addressing the emotional triggers, caregivers can create a more supportive and understanding environment for those living with dementia.
Managing the behaviour
Understanding the underlying causes of nose picking in dementia patients is the first step in managing the behaviour. Here are some strategies that can help:
- Regularly check for nasal problems, and consult a doctor if there are concerns about infections or other medical issues.
- Provide tissues and encourage their use, gently reminding the person about the importance of hygiene.
- Engage the individual in activities to distract from the behaviour and reduce boredom.
- Stay calm and avoid drawing attention to the behaviour, as it might increase anxiety or agitation.
A compassionate approach
It’s essential to approach the situation with compassion and understanding. Remember that the person with dementia might not be aware of their actions or might be doing it for reasons they can’t communicate. Responding with patience and kindness can make a significant difference in their well-being and comfort.
By gaining a deeper understanding of the reasons behind nose picking in dementia patients, families and carers can take proactive steps to manage the behaviour, ensuring a better quality of life for their loved ones.
Open dialogues with healthcare professionals can also provide insights into individualised care plans that address specific behaviours. By fostering an environment of empathy and support, not only can challenging behaviours be managed more effectively, but the bond between the patient and caregiver can also be strengthened. Through collaboration and continuous learning, we can ensure that those with dementia receive the dignified and respectful care they deserve.
Dr Lucy Hemmings is a neurologist specialising in behavioural changes in dementia patients. She has over 15 years of experience in the field and frequently contributes to health and wellness platforms, sharing her insights and expertise.