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Topical creams can be helpful, as well as a good moisturizer (such as Cetaphil or Eucerin cream) but I'd check to see how often memory care med techs actually apply them, and to what areas of her body.
Hospice may be a good resource, as the focus here is on her comfort and quality of living, but not necessarily extending the length of her life - if you feel that is what she would choose for herself if she understood her situation.
Will be thinking of you - this is such a hard place to be.
Then put that label on a big lotion bottle and tell her to us as needed. This might give her a different obsession but, at least it will not be potentially dangerous to her health.
This disease just sucks.
Google this: geriatric psychiatry in seattle wa
What causes floaters?
Eye infections.
Eye injuries.
Uveitis (inflammation in the eye)
Bleeding in the eye.
Vitreous detachment (when the vitreous pulls away from the retina)
Retinal tear (when vitreous detachment tears a hole in the retina)
Retinal detachment (when the retina gets pulled away from the back of the eye)
https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/floaters
I would say that if you think you see some bugs on the wall or the sheet and don't know it's a floater, your brain would go to 'now my skin is itching'. Just like if someone talks about lice and then my own head itches.
I had a PVD issue (similar to retinal tear, but it's really just a small blob of the vitreous that pulled away). Each blink makes the darn thing flap. Told by several eye drs that you just learn to live with it. Then found out that some people get them after cataract surgery and dr goes back and repairs it. So will be scheduling cataract surgery with a doctor who repaired the PVD for someone I know.
If this lady can sit for a good eye exam, it may be quite helpful to her.
https://www.amazon.com/s?k=alzheimers+mittens&crid=3G0E2H132M3F7&sprefix=alzheimers+mittens%2Caps%2C116&ref=nb_sb_ss_retrain-deeppltr_1_18
IF she will keep them on her hands, that will prevent bleeding skin. Keep her nails very short also.
My aunt with advanced Alz would pick at her scalp until there was no hair left in certain areas. It's a sign of agitation in a person with dementia. Have you spoken to MILs doctor about medication to calm her down? While you say there are 'limited hallucination and delusional medication options', I'm quite sure there are calming medications available to her that WOULD address the agitation she is experiencing. Ativan worked quite well for my mother during the advanced stages of dementia when she was very agitated and insisting things were happening that weren't.
Also, at mom's Memory Care, the caregivers would come get her dressed and out of her room every morning by 10 am. They'd bring her into the activity room to keep her occupied and engaged with the other residents doing a puzzle, eating, or an arts and crafts project of some sort. Such a thing may help MIL keep her mind OFF of these bugs she's obsessing about in her room. Have you spoken to the staff about what THEIR plan is to prevent her from decimating the walls and herself?
Wishing you the best of luck with a very difficult situation.