Why do people with dementia touch themselves? A look into the underlying causes

According to the Alzheimer's Association, repetitive behaviors are common in many forms of dementia, affecting a significant portion of the population [1]. This behavior, which prompts the question 'Why do people with dementia touch themselves?', is not random but rather a complex symptom tied to underlying neurological and emotional changes.

Quick Summary

Repetitive self-touching in individuals with dementia often arises from neurological damage impacting sensory perception and impulse control. It can also be a non-verbal coping mechanism for anxiety, boredom, or a way to communicate unmet physical or emotional needs, serving as a form of self-regulation.

Key Points

• Neurological Changes: Damage to brain regions controlling impulse and emotion often leads to repetitive actions, including self-touching.

• Sensory Regulation: The behavior can be a form of self-soothing or an attempt to process altered sensory input, providing a sense of grounding.

• Non-Verbal Communication: When speech declines, self-touching may be a way for individuals with dementia to express needs, pain, or distress.

• Emotional Coping Mechanism: High anxiety, stress, or boredom can trigger self-touching as a way to find comfort and security in a confusing world.

• Environmental Factors: Overstimulation or lack of stimulation can both contribute to repetitive behavior, which can often be redirected with a change in activity or environment.

• Caregiver Empathy: Effective intervention depends on understanding the underlying cause of the behavior rather than simply focusing on the action itself, requiring a compassionate approach.

Understanding the Neurological Basis

Dementia, particularly diseases like Alzheimer's, causes progressive damage to various regions of the brain. The frontal and temporal lobes, which are crucial for impulse control, judgment, and emotional regulation, are often affected. This damage can lead to a breakdown in inhibitory control, resulting in disinhibited and repetitive behaviors, including self-touching. The basal ganglia, another area involved in habit formation and motor control, can also be impacted, contributing to the repetitive nature of these actions.

Disrupted Sensory Processing

For many people with dementia, the ability to process sensory information correctly is altered. The brain may no longer register touch in the same way, leading to a need for increased tactile stimulation. Self-touching can be a way for the individual to ground themselves and seek familiar sensory input in a world that feels increasingly unfamiliar. Conversely, some individuals may become more sensitive to touch, and their actions might be a reaction to a sensation that is irritating or overwhelming.

Psychological and Emotional Factors

Beyond neurological changes, the psychological and emotional state of a person with dementia plays a significant role in their behavior. The progressive loss of memory and cognitive function can be distressing, leading to high levels of anxiety and frustration. Self-touching can be a form of self-soothing, a way to provide a sense of comfort and security when their surroundings and internal state feel chaotic. This behavior can be likened to a child sucking their thumb or a person fidgeting when they are nervous.

Communication Breakdown

As verbal communication becomes more difficult, individuals with dementia rely more on non-verbal cues. They may touch themselves to communicate something they cannot articulate, such as pain, discomfort, or an unmet need. For example, a person might repeatedly touch their arm to indicate it's sore or stroke their chest to express anxiety. For caregivers, learning to interpret these new forms of communication is crucial for providing effective support.

Environmental Triggers

The environment can also influence repetitive behaviors. Boredom, lack of stimulation, or overstimulation can all trigger self-touching. In a quiet, uneventful environment, the individual might seek stimulation from their own body. Conversely, a noisy, chaotic environment can cause distress, and the individual may touch themselves to retreat inward and find a sense of calm.

Practical Caregiving Strategies

Effectively addressing repetitive self-touching requires a compassionate and patient approach. The first step is always to rule out any underlying medical causes, such as pain, hunger, or needing to use the restroom.

Here are some strategies for caregivers:

1. Assess the cause: Try to understand the 'why' behind the behavior. Is it anxiety, boredom, or a physical need? This understanding will guide your response.
2. Provide redirection: Gently redirect the individual's attention to a different activity. This could be a favorite song, a simple task like folding laundry, or holding a soft object.
3. Offer sensory stimulation: Provide safe, alternative sensory input. Fidget blankets, stress balls, or a soft, comforting blanket can offer a positive outlet for the need to touch.
4. Create a calming environment: Reduce environmental triggers by maintaining a calm, predictable, and low-stress atmosphere. Use soft lighting, quiet music, and a structured routine.
5. Engage in meaningful activities: Provide opportunities for simple, engaging activities that match their cognitive level. This could be looking at old photos, listening to music, or light gardening.
6. Validate their feelings: Acknowledge their frustration or anxiety. Sometimes, a simple, comforting touch or a reassuring voice can be all that's needed.

Types of Repetitive Behaviors and Interventions

Behavior	Possible Cause	Intervention Strategy
Hand-wringing	Anxiety, frustration, restlessness	Offer a stress ball or a warm cloth; provide reassurance.
Hair-pulling or stroking	Self-soothing, seeking comfort, boredom	Offer a soft object to hold; engage in a distracting activity.
Skin-picking	Itching, discomfort, anxiety	Check for skin irritation; apply lotion; provide sensory alternatives.
Touching clothes	Discomfort from tight or scratchy clothing	Ensure clothing is comfortable; offer a soft blanket.
Pinching	Pain, frustration, inability to verbalize discomfort	Check for physical ailment; provide gentle massage or holding.

The Role of Empathy and Understanding

Understanding that repetitive behaviors are not intentional or malicious is vital for caregivers. They are symptoms of a disease and require empathy, patience, and a problem-solving approach. By focusing on the potential causes—whether neurological, emotional, or environmental—caregivers can move beyond simply reacting to the behavior and instead provide meaningful support. This shift in perspective transforms a challenging behavior into a communication signal, offering a path toward better understanding and care.

For additional resources and support, caregivers can consult authoritative sources such as the Alzheimer's Association. For more information, visit the Alzheimer's Association website.

Conclusion

Repetitive self-touching in individuals with dementia is a multifaceted issue driven by a combination of neurological damage, sensory changes, emotional distress, and communication difficulties. While it can be distressing for caregivers, viewing it as a symptom rather than a deliberate action is key. By understanding the root causes, implementing practical strategies, and approaching the situation with empathy, caregivers can better support their loved ones and improve their quality of life. The challenge lies in adapting to a new way of communicating and seeing the world through the eyes of someone living with dementia.

Frequently Asked Questions

Is it normal for a person with dementia to constantly touch themselves?

Yes, repetitive self-touching is a common behavior among individuals with dementia. It is often a symptom of underlying neurological changes, sensory issues, or emotional distress and should not be seen as intentional or malicious.

How can I stop a person with dementia from touching themselves?

Instead of trying to 'stop' the behavior, it's more effective to redirect it. Offer an alternative sensory object like a soft blanket or a fidget toy. Identify and address any underlying causes, such as anxiety or boredom, to reduce the behavior.

Could repetitive touching indicate pain in a dementia patient?

Yes, it is possible. As communication abilities decline, a person with dementia might use self-touching to signal pain or discomfort in a specific area. It's crucial for caregivers to assess the person for any physical issues or signs of pain.

What if the self-touching is becoming obsessive or harmful?

If the behavior becomes obsessive or results in harm, it's important to consult a healthcare provider or a dementia specialist. They can help determine if there is a medical issue, adjust medications, or provide specialized strategies to manage the behavior.

Can boredom cause a person with dementia to touch themselves?

Yes, boredom and lack of stimulation can be a trigger. A person with dementia might turn inward and seek stimulation from their own body if they are not engaged in meaningful activities. Providing simple, engaging tasks can often help.

What is the difference between self-soothing and repetitive self-touching in dementia?

While repetitive self-touching can be a form of self-soothing, not all instances are. Self-soothing is a calming behavior in response to distress. Repetitive touching can also be caused by neurological misfiring or a sensory need, even when the person does not appear distressed.

How should I respond when a person with dementia touches themselves repetitively in public?

In public, remain calm and discreetly try to redirect the behavior. You might offer a comfort object or gently engage them in conversation to shift their focus. Remember that this is a symptom of their disease, not a reflection of you or them.