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Why is my Mom with Alzheimer’s dementia pulling her hair?

It can be very scary and disturbing to see your loved one pulling her hair out.

“She has been pulling her hair harder and harder. At first, it didn’t seem like a big deal, but then she started yanking on her hair more frequently. Now it seems like her hands are always in her hair and sometimes she makes her scalp bleed. She’s hurting herself, and I don’t have any idea what to do. ”

“It freaks me out. I try to patiently and gently move her hands away, but then she’s pulling her hair again the next second. Finally I end up yelling at her to stop but that just makes her scared and upset. I feel awful.”

People with Alzheimer’s, Huntington’s, Pick’s, Parkinson’s, dementia with Lewy-bodies, and other forms of dementia sometimes develop repetitive behaviors such as hair pulling. It might be more common in women than in men.

What are the causes of hair pulling?

There is a condition called Trichotillomania, which is characterized by an obsessive urge to repeatedly pull hair out of one’s scalp, eyebrows, armpits, arms, or all over the body. Generally, Trichotillomania is considered a form of obsessive compulsive disorder focused on the body. It often starts in childhood and can be a life-long disorder. However, many people report that hair pulling develops for the first time in people who have dementia.

The connection between Trichotillomania and dementia is not perfectly understood. However, all humans have a deeply ingrained need for repetitive, rhythmic movement. Some of our earliest sensations are from being rocked and jostled in our mother’s womb. For centuries, parents have rocked their babies and children to sleep because the rhythmic, swinging motion is deeply soothing and comforting. It is natural for people of all ages to continue to crave rhythmic movement – running, dancing, swinging our arms as we walk, tapping our toes to music. Why do you think we invented rocking chairs?

Although we all have a natural need for repetitive movements, it can be worrisome and potentially harmful when people channel that need by pulling out their hair.
Below are some possible reasons that someone with dementia, who did not previously have Trichotillomania, might start pulling on her hair.

Boredom
Boredom, depression, and sensory deprivation are extremely common among people with dementia. First of all, many people with dementia receive minimal sensory input because their physical senses are diminished, e.g., they can’t see or hear as well as they used to, their sense of taste isn’t as good as it used to be, etc. On top of that, it is very difficult for caregivers to constantly find appropriate, meaningful activities to engage and stimulate the person with dementia. When people do not receive enough sensory input, they will start creating their own physical sensations, in whatever way they can. Sometimes that means yanking, twisting, tangling, or pulling hair.

Attention Seeking
Communicating with someone with Alzheimer’s or dementia can be challenging. They might not be able to explain that they are in pain or to clearly express that something is bothering them. Hair pulling might be a cry for attention. Especially in less verbal patients, hair pulling can be a way to get attention and convey that something is wrong.

Self-Soothing
Hair pulling can be a way for people with dementia to comfort themselves and cope with a variety of difficult emotions, such as confusion, frustration, or anxiety. If the episodes of hair pulling seem to come right after a person becomes upset, it might be a subconscious form of tension release.

Pain relief
Some people might pull their hair when they are in pain or physical distress. The sensation of pulling the hair from their scalp or body can be a distraction from other pain that they are experiencing. Pay attention to warning signs of pain, such as grimacing, shortness of breath, grunting, or moaning. If you suspect that a dementia patient is in pain, talk to a medical professional to find the best course of treatment.

Can I do anything to stop my mom from pulling out her hair?

Safety first. Check with your medical professional to find out if there is an undiagnosed medical problem causing pain or hair pulling. To prevent scratching and infection, it is advisable to keep the person’s nails trimmed and clean.

Luckily, there are a number of ways to increase sensory input and provide meaningful activities to prevent boredom, sensory deprivation, and other causes of hair pulling in people who have Alzheimer’s or dementia.

Consider whether any of the following tips are appropriate in your case:

• You might be able to minimize the behavior by making the hair less accessible. For example, if they pick at the hair on their arms, see if they will tolerate long sleeves. If they mess with the hair on their heads, see if they will happily wear a hat (or if it only attracts attention to the area and makes matters worse).
• Introduce a brush with very soft bristles. Some people find that brushing their hair fulfills a similar need to hair pulling, without causing as much harm.
• Provide other opportunities for repetitive movements by playing rhythmic music to encourage toe-tapping and clapping.
• Offer geriatric massage to provide comfort and physical connection
• Increase sensory input by providing things to smell, taste, and touch
• Use a Geraplay Activity Mat to give their fingers something to do besides pulling at their hair. An Activity Mat can keep their hands busy with meaningful sensory input and provide a safe outlet for repetitive behaviors. Geraplay Activity Mats are specifically designed to give people with dementia something to pull on and pick at, so they won’t hurt themselves.

Although it is not well understood, hair pulling outside of Trichotillomaia, might simply reflect a natural tendency for rhythmic movement. Nonetheless, it can be disturbing and potentially harmful. The more often a person pulls her hair, the more likely it will become a habit. To prevent the behavior from becoming more frequent, try to gently distract and redirect the person as soon as she starts reaching for her hair.

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