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Luvmydaddy Asked August 2013

My 89 yr old father picks his nose and won't stop. He's landed in the ER several times from excessive bleeding. What can I do?

My 89 year old father won't stop picking his nose even though we have begged him to stop. My 83 year old mother is his primary caretaker and it is very hard on her. Her health is not good and she can't handle anymore emergencies. He has been rushed to the ER several times when the bleeding couldn't be controlled. He has congestive heart failure and is receiving palliative care. He takes Plavix so when he bleeds it can be very dangerous. I have looked him in the eyes and have plead with him to stop to only have him do it immediately afterwards. His care has been very difficult without this issue. It sounds cruel, but we have even threatened him with being placed in a facility to no avail. It's coming close to fruition because my mother can't handle much more. My siblings and I have talked to him till we are blue in the face but he won't stop. Needless to say, it's a constant worry because we can't follow him everywhere he goes. He is homebound. He has to use a walker so he is relatively mobile but it is an effort for him to do everyday things. He usually does it in private, i.e., when he is the bathroom or at night when my mother is sleeping (and she hasn't been able to get much sleep because she has to constantly check on him.). We have tried repeatedly to explain the consequences of his actions, but it just doesn't sink in. He will say, "I guess I'm just stupid." It's heartbreaking, frustrating and scary. And unfortunately, the medical people don't seem to be much help. Go figure. Any suggestions would be much appreciated. I am very worried about how much more my mother can handle and I can't stand the thought of him being placed in a nursing home because my mother can no longer take of him at home anymore,

ferris1 Aug 2013
I recommended to anewleaf she try the neurological Botox which is different from cosmetic Botox administered by a neurologist and insurance will pay for it. Injections are given in the frontal region above the eyebrows and at the base of the neck. I suffer from migraines, and after one month this treatment has greatly improved my migraines. The added benefit is very clear sinuses and my nose feels very open. Try it and see if it might work! Good luck.

debbierose Aug 2013
anewleaf your situation sounds so much like my moms. She feels like there is always something in there and has suffered with sinus problems off and on for years. She says she can't breathe. She has been to ENTs and they have been of no help. We took her to one about 2 weeks ago and he told her her septum is one. He cauterized it and told her leave it alone and if you must blow do it very gently. Well as soon as we got home she blew her nose as hard as she could! Which caused her nose to bleed. I think with her she started out with a very real problem years ago and it turned into an obsession. She uses saline sprays several times a day, we bought her a cool air humidifier and even a battery operated nasal irrigator. She says it helps but still keeps picking and blowing away. I am sympathetic, it's just so hard to deal with with her living with me. I have resigned myself to the fact that this will not stop. It is so frustrating. Trying to get her to wear gloves or mittens would go over like a lead balloon, but maybe it could work with someone with dementia. luvmydady I'm sorry you are having to deal with this too and hope you can find something that will work for your Dad.

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LadeeC Aug 2013
In our case, it was mostly because her entire nasal/throat area was terribly dry. The ENT Doc recommended 2x/day simple saline nasal spray and room humidifier/vaporizor (depending on time of year/heat, etc) and it has made a huge difference.

adri2375 Aug 2013
Grandma has been doing the same thing - nose picking inside nose till it bleeds but not quite as frequently as your dad...it is annoying, embarrassing (especially during mealtimes) and I don't want her to cause more issues with having the inside of her nose raw! I have cut down her index fingernails, taken away tissues and provided her with a soft hankie daily (going green here too!) she has not been obsessing as much but it is still an issue. She says she feels stuffy and that her nose runs (it is clear so I am thinking allergies). I have started her on regular Claritin & using saline nose spray 2x/day or more. It has been helping somewhat. Just got an rx for Flonase so we will fill it and try it. Sometimes the drs/er make you feel like you should be able to stop such things like we are at fault, others tell me it is OCD so give her an extra anxiety pill which I need to try because sometimes I think she is doing it purely to do something not that there is an actual issue in there but that she is obsessing about something else and is taking it out on her poor nose! Good luck! I am in the same boat as you are right now!

Tsoto1 Aug 2013
Can it be cauterized? Thats what they suggested for my MIL.

anewleaf Aug 2013
This is a very interesting topic for me, because I am a compulsive nose picker and can add something from that perspective. I am 68 now, but I have been doing this for years. It has been maybe 5 or 6 years since I had my last bout with heavy clots of bleeding, but I seriously worried about hemorrhaging. Why do I do it? I can't stand the feeling of anything I perceive as an obstruction in my nose and have to get it out. I have had periods of chronic rhinitis as well as periods when my nasal passages have been very dry but somehow seem to have buildup of dried mucous that needs to be removed in order for me to feel that I can breathe. I have been to ENTs before and they say there is nothing wrong with my nasal passages. I have had sleep tests for apnea which have been positive, but I can't tolerate a c-pap or bi-pap because of excess salivation or nasal secretions. Besides, in my mind at least, I feel like the obstruction is in my upper nasal passages rather than in my throat or esophagus. No matter what it seems like to you as an observer, don't assume that your person of interest is doing it because of dementia or attention-seeking or to annoy you. Be more sympathetic and try to find out what he/she is really feeling if it's possible. I, myself, would like to know what it going on. I don't feel like any medical doctor cares less or wants to get to the bottom of it, so I've quit trying. My kids are humiliated by it, and I try to be as inconspicuous as possible, but I honestly feel as though I can't breathe. This is even when I can feel air going in and out.

ferris1 Aug 2013
Perhaps the doctor can prescribe a medication which will not interfere with the Plavix to allow him to sleep and so your mother can get some sleep. Along with that his hands can be taped so he cannot get at his nose. I'm not sure if you mean he is picking on the outside or the inside of his nose. He can wear mittens unless someone is with him, and you can surely hire help to come in and give your mother respite. Either the doctor feels this phase will pass, or with many terminal patients the medical community tends to offer no solution. A sleep aid, a med for anxiety, and help so your mom can get some respite will be all the help this nurse can give you.

Gigi11 Aug 2013
You say the medical people aren't any help but have you asked his primary care about a medication to calm the OCD behavior? Another factor may be that he has a desire to control others. No matter what the cause, this game he's playing has only one rule: You lose.

balexander9 Aug 2013
In patients with dementia (and some children with autism) compulsive nose picking is often an OCD kind of behavior that has a sensory component. It is similar to someone who compulsively picks at scabs or compulsively masturbates. I doubt the nose picking has much to do with feeling that that there is something in his nose. Medication for anxiety/OCD might help. Other than that, I have no suggestions and can only offer sympathy.

50sChild Aug 2013
My 100-year-old MIL was agreeable to wearing cotton gloves because she picked at herself especially at night. I'm not sure your father would, nor would he probably wear a "nose piece." I wonder (please someone tell me if this is cruel) if rubbing capsaicin into handcream and telling him the cream is required might stop this. But it sounds that your father is unreasonable, and that raises larger issues. Even if this behavior is nipped, it is likely something else will become an issue for him. Sometimes I feel carecaring a mentally declining elder is like a game a chess requiring not only superior creativity, but also psychological and body-endurance Olympics.

blannie Aug 2013
You don't mention dementia, but does he has any cognitive decline? How does he explain why he picks his nose? Does it feel like there's something in there he has to get out...does his nose hurt? Or does he just have an uncontrollable feeling of wanting to pick? If that's the case, it's almost like an Obsessive Compulsive Disorder (OCD) thing and some kind of anti-anxiety medication might help. It sounds like it's something he can't help based on what you've written. I'd get him to a neurologist to see if some kind of anxiety medications might help.

cmor1954 Aug 2013
My mother-in-law who is gone now did this nose picking. She would then call the emergency ambulance people and go to the hospital. She was attention-seeking. She got so she would actually request a specific driver. We figured the cost of her ambulance rides in the thousands of dollars. She was attention-seeking. The family could not fill this void, she wanted to be around strangers so she was 'new' and 'special'. After her ride and visit, she would act special and brag about how the ambulance driver said how smart she was. As their world gets smaller they can obsess on things. Perhaps he needs something of his 'own' like - putting a puzzle together or something to keep his mind busy he could do even in the night - so that he would feel enabled and independent. Perhaps reminding him who 'he' is again. Aging is so 'lossy' - sometimes something simple will reverse someone's negative habits if he can get his mind engaged on something else.

debbierose Aug 2013
I can't offer any advice that would be of much help, but my mom has a similar problem. Even though she has no septum left, it's just a big hole in her nose, she thinks it is always blocked and because she is on oxygen 24/7 she thinks the air can't get through her nose. Hence she is digging in there all the time, and blows her nose harder than anyone I've ever seen about 20 times a day, plus uses saline spray I don't know how many times a day. All this causes her nose to be irritated and swollen inside. It bleeds, sometimes a lot of clots of blood come out, she puts bacitracin ointment with a q-tip 2-3 times a day as well. And even irrigates with a battery operated sinus irrigator to flush stuff out. It is a vicious circle! All because she won't leave it alone long enough to heal. And I believe it has turned into an obsession. Even though I, my husband, and a few doctors, plus her home nurse has explained to her what's happening she still will not stop. Could it be possible this is what it could be with your dad, an obsession? I know how frustrating something like this can be, and sorry to hear you and your family, especially your poor mom have to deal with this. My mom had to go to the hospital about three different times because of serious nosebleeds before we went and got her and brought her to live with us. I'm surprised she has not yet had to go to ER since she moved here. Just a thought, maybe an ENT doctor may be able to do something? I know there's the chance it could be an obsession and if so he most likely will not stop. Sorry I can't give you any other ideas but I do know somewhat about the worry and utter frustration you are going through. I agree this has to be very stressful and scary for your mom. If you do come up with a solution please let us know. I too hate the thought of a nursing home, but these kind of caregiving issues can be so draining, especially when there are constantly other matters you have to deal with on a daily basis. I have told my mom I will care for her for as long as I can, and if the day comes when I can't handle it we will have to talk about NHs. It it all so hard. My mom has been here almost 3 months and I and my hubby already have many symptoms of caregiver burnout. I pray for strength and patience and guidance every day.
Blessings to you

Perseverance Aug 2013
Are they living alone in their own home? Why not hire in-home caregivers before sending him to a facility? Regarding his nose picking, perhaps he needs help blowing his nose regularly? What does his doctor suggest?

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