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Mom's in advanced stage dementia at this point, but is lucid enough to know if anyone is doing anything to her hands. She won't let anyone - and I mean ANYBODY - trim, file, or clean her fingernails. It's really disgusting and unsafe for the care workers at the dementia home. She fights pretty vigorously, scratches, claws, and is really aggressive about it. I believe she is breeding the next plague with the gross mess trapped under her nails.

I haven't run into this problem before on this site, so I thought I'd ask what has worked for others in this situation.

We have tried the rational approach, which everybody with any experience with dementia knows doesn't work. "Please", "I'll paint your nails if you let me...", "you're going to hurt yourself", etc.

I've tried distraction with music and talking to just try to wipe underneath with a bathing wipe. No good. None of us have any intention of getting slapped and scratched by her over this.

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We have had a MIRACLE!

Mom let the hospice nurse cut her nails today! Happy Happy Joy Joy!
All you guys thinking good thoughts for me on this must have helped.

Now that I think about it, if I hadn't cleaned out from under the nails the other day, clipping would not have been possible. Maybe mom couldn't feel how long her nails were anymore and didn't believe anybody about it. Things that make you go hmmm......
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Uh?

Oh the poor love. This disease is indeed a puzzle, but frankly I have more colourful words for it too.

If you're going to resort to force majeure, it's a two person (minimum) job. One to talk to her, the cutter sitting back and out of direct line of sight; you might need a third to restrain the operative arm gently, too. The more firmly you can prevent her wriggling, the less likely she is to get hurt or bruised. Try lasso-ing her wrist with a rolled towel and placing it on a firm surface. You might need a third person to hold her arm still, but gently. It's like with holding chickens (whole body grip, pinioning wings, should anyone happen to need this information) or giving a cat a tablet (mummify in bath towel) - you go in hard, no-nonsense, aiming for total immobilisation; and then there's no opportunity for resistance, no flapping and no accidents. And actually a happier subject at the end of it, because the opportunities for major traumatic melodrama have been eliminated.

Phewf. I think I'd try anything else first! The combination of unco-operative mother and sharp nail scissors doesn't bear thinking about. If it isn't working, stop; and consider cotton gloves as an interim measure.
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Sedation is something I'm going to talk to the hospice nurse about. Otherwise, we need to hold her steady and just get it done - mad or not. Just like we'd do with a baby who has ragged nails.

She's taken to pinching her right earlobe with her right hand nails really hard. Sometimes she will holler out "OW MY EAR!!" and I have to take her hand away. She has no idea she's doing it to herself. This disease is such a puzzle even for the experts.
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Sunny makes a good point about the health issues of being scratched by the nails, or infected with who knows what if they come in contact with open wounds.

Maybe sedation and restraint is appropriate, just to protect her from some infection and/or contamination, not to mention those nails coming in contact with any food. Yuck.
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Has she gone off warm water, too, Sandwich? I'm just wondering if you could get her to put her hands into a nice sudsy bowl, maybe squeezing sponges or give her something to wring out, for a good soak first? Playing with toy boats or rubber ducks might not be terribly dignified, but anything that gets her hands warm and wet would be a start. Maybe if it's fun and feels nice she'll go along - to start with anyway, heh heh heh...
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Mom did love to get her nails done, but polish only. No clipping or filing even before her current advanced state. We've tried every trick to get her to agree and be on board with this. And I know those techniques do work really well a lot of the time.

Sadly at this point, mom's pretty far gone reason & understanding-wise. If she's asked to raise her arm or offer her hand, she can't. You have to do it for her and hope she doesn't resist. She's extremely good at resisting!

I think I'll try the silent approach and take her hand, clip the worst one or two and see what happens. If it goes OK, then one more, etc.
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You beat me to it, Blannie! Sorry.
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If you were to sit by her and, humming a cheerful tune, do your own nails, fairly theatrically and with many an admiring glance, might she possibly get beauty treatment envy? You'd have to have the whole kit: soaking basin, fluffy warm towel, hoof sticks and all the rest of it. But the worst that can happen is that it doesn't catch on and you're no further forward - plus you give yourself a nice manicure.

Failing that, is there a visiting chiropodist with some tips on treating recalcitrant dementia care residents?
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It's great you made some progress. Have you talked to her doctor about it? I would be concerned that if she scratches her eye or ear with those dirty nails, it could cause a vicious infection. I know that anesthesia is to be avoided, but what about some light sedation in order to get them really clean and nicely trimmed. Not every week, but once in awhile. I guess it's the risk versus the benefit.
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When I took my mom to the podiatrist, I was surprised to see he used basically a Dremel tool that IS like a little sander. I bet the podiatrist could make fast work of her fingernails if he uses something like that. It might be worth a call, just to ask. If she let him do her feet, maybe she'd let him work on her hands too. Otherwise, a sedative sounds like the best idea. Do you ever offer to paint her nails? My mom still loves that at 95. She has better nails than I do (at 65) which is kind of distressing, LOL!! Maybe you could do the "soak in Palmolive first like Madge did on TV", then cut them? She'd probably remember those TV ads. Just throwing out ideas here...
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So mom had to be taken to the ER night before last (long story but she's OK), and while we were waiting, she was dozing pretty hard. I grabbed some of the ER/hospital grade cleaning wipes and started going at her nails.

I'm hard to gross out, but I almost barfed with what came out from under there. One whole wipe per finger was necessary. The smell was unholy. I'm pretty sure I know what that was and I don't want to think about it.

So, it looked better than before, but until she can get a solid hydrogen peroxide soak and scrub, that may be the best that's possible. When I talked to the nurse supervisor in her unit, he was THRILLED that I had been able to do that!

I didn't get to trim any of the jagged/rough nails though. Baby steps.
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Yep...Advil PM and it would be done..but that's just me!
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Mom always had very short nails due to the work she did as a textile mill seamstress and tailor. She always coveted long pretty nails. I think a lot of her meds over time also contributed to weak & brittle nails.

Now that she has the longest nails of her life, she is not giving it up. No matter what. About a year ago, I tried to trim off a millimeter of jaggedness, and nearly had my face handed to me. It has not gotten better! She thinks she can do it herself, but she no longer has the strength in her hands or the comprehension to use a clipper safely.

I am going to suggest to the staff and hospice nurse that they do give her a sedative for this. I'll do the dirty work myself. It's too bad the podiatrist that manages the talons on her feet can't do hands too.

If this had to be a dental intervention, she would have to be sedated.

I would love to know how they got her to sit still for the last toenail care event. They really were talons with a pretty vigorous case of foot fungus, so the nails were very, very thick and tough in addition to being quite long. She refused foot care for a long time, but the visiting podiatrist got it done somehow. Get out the belt sander and tree trimmer!
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Wow, this must be so frustrating, and as you suspect, unhealthy.

I'm wondering if she always kept her nails manicured and was very proud of them. If so, perhaps it's her way of clinging to her past.

Or perhaps she's fearful in her current condition and has some sense that the nails would protect her. And it does seem to be a deterrent.

I'm assuming also that getting her hair done, accompanied by a pedicure and manicure wouldn't work either?

The only thing I can think of isn't something I would really want to suggest, and it is that restraining or sedating her then clipping the nails would accomplish the job. But to me that's so cruel. And she would probably be livid when she discovers what's been done.

I know of only one other similar situation, but it was with someone's toenails. The individual was living alone and because of mobility limitations wasn't able to reach down to trim her nails. So they just grew and grew and grew.

I just don't know or have any good suggestions butwanted to offer my support for the stress this must be causing you. I hope others have some ideas; this must be so frustrating.
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