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After 7 years in 2 different AL facilities (different states) my 90 year old mother is now immobile in skilled nursing after a serious septic infection. I visit her twice a week. She is on oxygen alot of the time.


She has this terrible habit of picking at her lips and gets caked blood under her fingernails. Each time I go I soak her fingers, brush them, use a tool to remove blood and file her nails. This is depressing and exhausting.


Does anyone think there is any point to asking the doctor overseeing residents if any medication would possibly work to help alleviate this habit? My visits become all about doing this as the caked blood does not loosen easily.


My mother is a kind person. We are very different and have had different values in life. She has not had the maternal instincts I have. My 3 grown children love her which is nice. There have been periods of time throughout my life when she had health issues.


I know I am not God. I am having a hard time understanding the purpose to her life. I know I share that sentiment with others here on Aging Care. I feel I need to clean her fingers as she can not do it for herself and they look awful. To be honest I have been embarrassed to be her daughter for a long time. I am her only child. I guess I am just reaching out to hear any points of view on this matter. Each time she seems glad to have her fingers clean but cannot seem to stop doing this. She has done it for years but now cannot wash her hands by herself.

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Oxygen is very drying. why are they not moisturizing her lips,, like chapstick? They used to say no stuff like vasaline, ( petrolium products) but there are tons of other moisturizers for lips out there these days!
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Riverdale Jan 2021
There is a tube of Vaseline next to her always. She picks at her lips despite that. I always wash her lips,dry them,apply a liberal amount of Vaseline and then pat off the excess but leave them moist. I think it's pretty hopeless. It's only since she became immobile that the issue with all the blood under her nails has occurred.
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Yes I think it's worthwhile to ask the doctor if a medication can help her stop this OCD type behavior. If not, and if Chapstick doesn't help, you might want to give up the exhausting task you've undertaken. If the visits are all about cleaning her nails, you'll come to dread them terribly and that's not good for either one of you. You want to do things to make the best of a bad situation, imo, not make it intolerable.

I have no idea why God chooses to extend some lives so darn long....long after the quality is gone. I wonder that myself all the time. My mother turned 94 on Weds and now she can't raise her upper body up in the bed, due to poor core strength and refusal to do PT. So I bought her an adjustable bed so it won't require 2 CGs to get her up. It's literally one thing after another on a daily basis.

Good luck, I hope this situation gets resolved
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Riverdale Jan 2021
Thank you for your reply. I actually thought of you when typing this in. Some days have become really difficult lately.
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If you put a couple drops of liquid soap and an oil, any kind even olive oil, in the warm water, it will help loosen the dried blood and brushing the nails will probably be sufficient to clean them.

Make the water as hot as possible and have her soak as long as possible, this will help as well.
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Riverdale Jan 2021
Thank you. I will bring an oil for my next visits. She always has had chapstick around. The habit just overpowers its use. I think she may even do it in her sleep as in AL there would be blood on her pillowcase and sheets.
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For babies, you have them wear mittens. Certainly this is not a new issue. I use a medicated lip balm as my CPAP machine dries my lips. My husband asked me years ago why would God allow him to have Alzheimer/Dementia? Some friends have also asked the same question - why us? As a woman of faith, I ask, "Why Not?" Faith is walking through life believing God is in control. I don't have answers but I do ask God to give me patience and understanding. It does not make sense that our loved ones (and possibly ourselves) seem to not have purpose in life when they no longer can live life. I trust you will find an answer and wish you well.
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Oh, Riverdale! I so feel for you.

I respected by mom but we never had the sort of mother daughter relationship I would have wanted. For the last 4.5 years in the nursing home, my visits were very much about doing her nails and trimming her facial hair. I really, really hated it.

I would call a care meeting about the skin picking issue. Medication may well help.

And yes, lip balm is definitely indicated.

Try to separate the fact that you find this task distasteful and think of it as "what if she didn't have a daughter? How do other residents get their fingernails cleaned and trimmed?"
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Riverdale Jan 2021
Thank you for your reply. I believe we have experienced the same sentiments. There is good in my mother but she was always odd in ways. Many relatives truly love her and I am glad she has that. It just has been very hard to be her daughter for many reasons. Most residents in this facility are so far mentally gone I imagine they are likely unaware they have nails. That is at least the impression I would have when I see them when I visit. Their demeanor is completely unchanged. Obviously this past year has been so difficult. I have several surgeries ahead for myself. I am trying hard to not feel overwhelmingly depressed.
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Perhaps keeping her nails cut quite short, might help with the blood and such getting underneath them. Also having her wear either gloves or mittens might help as well. Best wishes.
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My mom picked her lips until they bled for my entire life. About eight years ago, I told her to put Chapstick on her lips every night before she went to bed.

Cured the problem like magic.

She may pick at her lips because there's always a little piece of skin she can get hold of. Once my mom started using the Chapstick, her lips healed up overnight, there were no loose bits to pick at, and her mouth healed up after 70 years of incessant picking.

I've used Chapstick every night myself forever, and I never got cracked lips.

Ask the nursing home folks to put it on her at night just before bed and multiple time s throughout the day, like after meals. If she capable of doing it, get a few Chapsticks for her bedside table, and pocket. That may become her new habit.
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Hi Riverdale
Your moms situation has multiple components.
Skin picking. Keeping her nails clean and managing your distress with finding her needing more care when you visit.

Here is an article from Harvard on the topic of skin picking.

https://www.health.harvard.edu/blog/picking-your-skin-learn-four-tips-to-break-the-habit-201811281544

I believe CBD oil helped my DH Aunt with this problem. It seemed to help break the cycle.
It’s doubtful you can get CBD oil given in a facility but you might be able to get the doctor to put in your moms chart that her nails are to be brushed daily to keep the blood from accumulating.
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Just a comment on the use of Chapstick.    It may be okay for people not on oxygen, but it as well as some other similar products contain petrolatum, which should NOT be used when someone's on oxygen.   I've found that this isn't always a well known precaution.

I don't recall offhand what we used; it might have been Carmex, but I'm not sure.    I used to get organic lip protection from a supplier I met years ago.    None of the ingredients in her selection contained petrolatum.

Presumably the flammability of a petroleum based product in the presence of oxygen is the issue.   Whether or not it's a significant issue, we felt that it wasn't worth the gamble, especially since there are alternatives that are safer (and tastier too)!

Also checked Carmex ingredients; no petrolatum is listed.

I'm surprised the staff at the nursing home your mother is in haven't raised the petrolatum issue.

https://www.vaseline.com/us/en/contact-us/faq.html

This is what I've used in the past, just b/c it's more pure, is fragrant, and is healthier.  I'm not trying to encourage people to specifically buy this brand; it's just an example of an alternative to Chapstick.

https://www.woodspriteorganicbody.com/Luscious-Organic-Lip-Balms-15-oz-Tube_p_433.html

On a related issue, either one of the home care nurses or the oxygen supplier (I don't recall which) gave us a sign to post on the front door indicating that oxygen was in use and no smoking was allowed (anywhere near the house, although emphasis would be on the doors and windows).
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Riverdale Jan 2021
They did initially bring up the issue with a product for her lips and oxygen. Since her requirement for oxygen has lessened i think they feel it is not problematic and her lips scab over endlessly. I have provided numerous products for her over the years. At one point I believe they had her on a prescription product in the AL facility. She clearly is too far gone with this habit. I am going to try to bring up the issue of medication but I think they may be hesitant to add more to the amount she is taking for so many other issues. This morning I was awoken early with a call from them because she rolled over in bed and nearly fell off the bed. She is overweight. That is another issue I tried for years to help her with. My worst fear was that she would end up in a nursing home and be immobile and her weight would make everything more problematic. That is what I am living with now.
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