Individuals with Alzheimer’s disease, Huntington’s, Parkinson’s, dementia with Lewy bodies and other forms of dementia sometimes develop repetitive behaviors such as hair pulling.
This condition is known as trichotillomania and is characterized by a fixated urge to repeatedly pull hair out of one’s scalp, eyebrows, armpits, arms or all over the body. It is typically more common in women than men.
The link between trichotillomania and Alzheimer’s or dementia-related disorders is not quite understood. The condition is considered a form of obsessive-compulsive behaviors, and it often starts in childhood and can be a lifelong disorder. Yet, many people report that hair pulling occurs for the first time in people who have dementia.
Human beings have a natural, deeply ingrained need for repetitive movements, evolving from the rhythmic sensations of jostled in the mother’s womb. Further, these rhythmic patterns continued as mothers rocked their babies, which was deeply soothing and comforting to them. These rhythmic sensations offer comfort and ease of anxiety.
Though these repetitive movements are natural, it can be worrisome and potentially harmful when people channel these needs by pulling out their hair. There are a number of possible root causes for the onset of trichotillomania.
Because communication with someone with Alzheimer’s or dementia is very challenging, often these hair-pulling behaviors erupt when that person is trying to express a need or pain. The behavior can also be a means of gaining attention, conveying that something is wrong.
Just as rocking can be soothing, so can hair pulling. It becomes a means of coping with a variety of emotions the individual cannot verbalize. If your loved one tends to pull out his or her hair right after being upset, then it might be a subconscious way of releasing tension.
Depression, boredom and sensory deprivation are extremely common in the disease process. Caregivers struggle to provide appropriate, meaningful activities to engage and stimulate the person with dementia. Therefore, your loved one might be creating his or her own physical sensations like yanking, twisting, tangling or pulling her hair.
Or it could be a way to distract from discomfort. Pay special attention to warning signs of pain, such as grimacing, moaning or shortness of breath. And if you notice, report these to your loved one's physician to ascertain the best treatment. Additionally, check with his or her doctor to make sure there is no underlying medical issue that is causing the hair-pulling behavior.
Try minimizing the hair-pulling behaviors by making the areas where the hair is pulled less accessible, i.e., have them wear long sleeves or a hat, if possible. Distract him or her by playing rhythmic and encouraging them to tap their toes or clap. Give a comforting hand massage and increase sensory output by providing things to smell, taste, touch and see.
Another effective measure is to give him or her a brush with soft bristles. Brushing the hair often fulfills a similar need to hair pulling and can be very soothing. Additionally, redirect the hair-pulling behavior by offering some meaningful and purposeful activities, ones that she particularly enjoys.