As some of you may know, it can be very hard to tell whether or not your LO is in pain since they have trouble expressing themselves. The Alzheimer's Weekly for today had a link to a discussion on how to tell whether a person with dementia is in pain. It is quite simple and, I think, very useful. The link to it is:
www.painanddementia.ualberta.ca
You then have to register and sign in. There is a 45 minute video, and then 3 parts in Adobe which can be downloaded.
A good presentation to watch. I had indeed thought that AD sufferers had less sensitivity to pain; if I understand this presentation correctly, that is not true. They just don't express it. That is disturbing, We got some mosquitoes in the house last week and I was badly bitten and itching something terrible. I noticed that DH had some bites but he repeatedly said -- when I asked -- that the bites didn't bother him. I thought Oh, yes, he's not as sensitive as he used to be. He wasn't scratching them either, as far as I could see. He was irritable though. I wonder.
I learned some years ago that elders could be burned, cut, etc. because their nerve endings may be desensitized. That was the "PHYSICAL" explanation. It wasn't until later in my nursing career that I learned AD patients don't fit a classic mold in so far as their reaction, or lack thereof....to pain. They do indeed experience pain, but the brain is not always able to process it or express it as a physical symptom. Behavior changes, both subtle and extreme manifest from pain. From anger, agression, greatly increased confusion, to withdrawal and fear. Any sudden change in behavior could be a reaction to something as simple as a headache or stomach ache, or something much more serious. And they are NOT text book for each dementia patient. The PainAD scale is an incredibly useful tool for healthcare professionals, but also for the family caregiver. At Hospice we have the PainAD laminated cards with a ring on them that we can hand out to our caregivers, and they have also just begun putting them in the family info packets that we take to the patients homes. Very eye opening for health care workers and family caregivers alike.
I am going to have to try again and get it because about the time I started reading it my DH came home from being with a friend and I didn't want him to see it on my computer because he doesn't like reading about his dementia.
I have been thinking about this since watching the presentation last night. I got to thinking that the MYTH I had heard about and believed was something about AD affecting the brain in such a way that pain was no longer (so acutely) felt. This myth is not really addressed in the presentation.
Good link. In a care team meeting at the nh I asked the staff to be observent with John as he will not verbally express pain or illness. In the last 5 months he's had a uti, gout, pneumonia,flare up of dbd and edema all caught by me not the staff. In his pre dementia life a mild cold was a dramatic event. Now it's a guessing game. We know our lo the best and even if they're in a facility it's still our responsibility to be on guard.