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 Biting knuckles and chewing fingers 
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Joined: Wed Oct 28, 2009 11:53 am
Posts: 969
Location: Ocala, FL
Post Biting knuckles and chewing fingers
In between being fed spoonfuls of food, Dale puts his hands to his mouth and bites his knuckles. He also sometimes pushes the spoon away. When I asked why, he said he thought it was a snake.

When he tries to hold something to eat, he often bites his fingers as well as the sandwich portion in his hand.

Does that sound familiar?

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Leone Carroll (75); wife of Dale (75) who passed away March 23, 2011


Mon Feb 28, 2011 9:38 am
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Joined: Thu Dec 02, 2010 1:44 am
Posts: 93
Post Re: Biting knuckles and chewing fingers
Leone, Fran does not bite his knuckles but will bite his fingers eating a sandwich. I think Fran does this because his eyesight is very very poor. He can see at a distance, but nothing close up. So he cannot see that his fingers are in the way and will just chomp down on them at times. It is getting to the point where I will also have to feed him his sandwich along with the other food I feed him. I was told that Fran cannot see because of the brain not sending signals to the eyes. Bernie


Mon Feb 28, 2011 11:26 am
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Joined: Wed Oct 28, 2009 11:53 am
Posts: 969
Location: Ocala, FL
Post Re: Biting knuckles and chewing fingers
That sounds right, Bernie. Dale cannot obey instructions at all. His brain wants to agree .... but his body doesn't. That's why he can't stand or feed himself. That connection is gone.

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Leone Carroll (75); wife of Dale (75) who passed away March 23, 2011


Mon Feb 28, 2011 11:37 am
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Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3378
Location: Vermont
Post Re: Biting knuckles and chewing fingers
I'm guessing that part of the biting of fingers may also have to do with the inability to comprehend spatial relationships as well. Lynn

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Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.


Mon Feb 28, 2011 11:47 am
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
Post Re: Biting knuckles and chewing fingers
Right on, Lynn. Derek has that problem and can't eat sandwiches at all. I had to issue orders to the kitchen at the SNF telling them not to bring sandwiches. He doesn't bite his knuckles but he can't seem to figure out how to maneuver it into his mouth, even cut into quarters, and does often get his fingers in the way. He has a cereal,toast and juice breakfast at 6AM and then 'brunch' instead of lunch, at 10AM where he gets a large, hearty breakfast-type of meal instead of the soup and sandwich option. You would think finger-food would be a good choice but it does not suit him well at all.

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Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Mon Feb 28, 2011 12:17 pm
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Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3378
Location: Vermont
Post Re: Biting knuckles and chewing fingers
My dad had a horrible time trying to get food and drinks to his mouth his last 6 mo. or so. He had to be fed all foods at all meals. He wanted to be independent and do it himself, but it just wasn't working. The kids' sippy cups I bought were effective for a while, so some of you might want to try those for drinks or soups that don't have chunks in them. Lynn

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Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.


Mon Feb 28, 2011 1:21 pm
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
Post Re: Biting knuckles and chewing fingers
Sometimes Derek will let me feed him, sometimes not. He likes oatmeal [which he calls 'porridge'] and does pretty well with it using a soup spoon. Of course, a lot of it ends up in his lap. I usually feed him his omelet and breakfast meats, pancakes or waffles with a fork. He always turns the fork upside down [English style] and the food falls off.

Well, I'm off to see him now.

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Mon Feb 28, 2011 1:28 pm
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Joined: Wed Oct 28, 2009 11:53 am
Posts: 969
Location: Ocala, FL
Post Re: Biting knuckles and chewing fingers
Today at lunch was the last time I'll give something to Dale to hold to eat. He could not comprehend the concept at all and became very frustrated. His hands are just not useful at all.

And he constantly thinks something is in his hands. He keeps trying to give me something that isn't there.

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Leone Carroll (75); wife of Dale (75) who passed away March 23, 2011


Mon Feb 28, 2011 2:11 pm
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Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3378
Location: Vermont
Post Re: Biting knuckles and chewing fingers
Best wishes to you for a day filled with lots of challenges. Thinking about you and hoping you get some respite, at least in the evening. Lynn

_________________
Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.


Mon Feb 28, 2011 2:38 pm
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Joined: Wed Oct 28, 2009 11:53 am
Posts: 969
Location: Ocala, FL
Post Re: Biting knuckles and chewing fingers - Lynn
Thanks for your thoughts, Lynn. It seems that Pat and I are both struggling with similar issues. It wasn't long ago that Dale was far behind but the last three months have seen the progression speeded up in an amazing way. I'm feeling jet lag, believe me!

The visiting nurse was here today and they have renewed Dale's involvement with Palliative Care. He is not ready for hospice because his vital signs are good. Today, he was 112 over 68. However, his motor control is much less.

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Leone Carroll (75); wife of Dale (75) who passed away March 23, 2011


Mon Feb 28, 2011 5:44 pm
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
Post Re: Biting knuckles and chewing fingers
Leone, vital signs don't have squat to do with Hospice admission. Here is a link to a list used for AD Hospice admission: http://alzonline.phhp.ufl.edu/en/reading/hospice.php

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Mon Feb 28, 2011 7:27 pm
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Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3378
Location: Vermont
Post Re: Biting knuckles and chewing fingers
My dad's vital signs were pretty good even an hour before he died! But, because of his weight loss, that was what actually made a difference so that we could get hospice services. He was on about 6 mo.
Is Dale losing weight? My dad had lost about 100 lb. before he was put on hospice! Then, with the pressure sore issue and continual weight loss they finally considered him "failure to thrive." Duh. The criteria seem to be getting tighter and tighter. He was in really bad shape mentally and physically before he was given hospice services. I was amazed that he wasn't admitted months before he was. Lynn

_________________
Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.


Mon Feb 28, 2011 8:08 pm
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
Post Re: Biting knuckles and chewing fingers
My next door neighbor's husband was admitted to Hospice today [he's in an ALF and has FTD]. He hasn't lost any weight but he is mentally deteriorating rapidly. So I guess they are looking at things other than just overt physical condition. There seems to be a large disparity in admission criteria between one agency and another.

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Mon Feb 28, 2011 8:23 pm
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Joined: Wed Oct 28, 2009 11:53 am
Posts: 969
Location: Ocala, FL
Post Re: Biting knuckles and chewing fingers
Thanks, Pat. The nurses always ask if he is losing weight.... but how do I know? He could be. He is eating much less. Only time will tell if any of the other symptoms and conditions show up. Right?

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Leone Carroll (75); wife of Dale (75) who passed away March 23, 2011


Mon Feb 28, 2011 8:31 pm
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Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3378
Location: Vermont
Post Re: Biting knuckles and chewing fingers
Leone - can you get him to stand on a scale? When he goes to the dr. don't they weigh him? Does he wear the same size pants, shirts? If he's losing a lot of weight it will be apparent. My dad was wearing about size 38 - 40 pants when he moved into the ALF. Every couple of months we had to buy him smaller pants and shirts. Size 30 pants were too large by the end.
Pat is so right - different hospice orgs. use different criteria or at least interpret numbers differently. They will tell you that Medicare determines the criteria and they are the same everywhere. Not true from my experience.
Tonight a friend called me and said her MIL has taken a significant downhill turn (diagnosed in May with PSP) over the last 2 weeks and the dr. demanded that she be put on hospice today. She is now on hospice. She flunked hospice a few days ago. Lynn

_________________
Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.


Mon Feb 28, 2011 10:05 pm
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