Effective Pain Management In Dementia Patients

Pain is one of the most subjective and often one of the most challenging symptoms to treat. Of course, there are a wide spectrum of prescription pain killers available, but these often increase one’s risk of adverse effects, including the risk of  possible opioid abuse.

Believe it or not — each year, approximately 29,000 Americans die due to opioid overdose. Although these medications most certainly provide use within mental healthcare, it’s important to explore all your options, before you reach for potent drugs — especially for the elderly.

Considering around 50 percent of the 35 million dementia patients around the globe, suffer from pain, it’s important that we find not only effective, but safe solutions.

Is Your Loved One In Pain?

For those who care for someone with dementia, you know that communication can be challenging. This is why education is so important — the more you know, the better prepared you’ll be.

As changes occur in the brain, this can affect pain perception, leading to behavioral symptoms that are often caused by discomfort. Take agitation or aggression, for instance, as these symptoms often lead to the inappropriate use of anti-psychotics.

Although behavioral symptoms are common among Alzheimer’s patients, they may be a direct reaction to increasing pain levels. Ask yourself:

1. Is your loved one in pain?
2. If they’re not communicating that they are, how will you know?

Please be aware of potential signs, including:

• Abnormal facial expressions or grimacing
• Gestures, that may indicate stress
• Guarding of a particular body part
• Reduced range of motion
• An increase in blood pressure
• Restlessness
• Increased sleep
• Reduced appetite
• Increases in confusion
• Greater symptoms associated with irritability and aggression

It’s important to recognize these signs, as untreated pain not only leads to suffering, but as mentioned, inappropriate treatments. Instead of being prescribed anti psychotics for aggressive outbursts, the solution may be treating underlying pain. In turn, this can alleviate problematic behaviors. 

How Do I Help?

If you suspect that the individual you’re caring for is in pain, naturally, you’ll want to help them. Although medications are often our first-line of defense, there are not your only option. Before you opt for prescription drugs, go through the following steps.

• Step One — The very first step will be a thorough assessment. Keep track of any changes, making notes daily. Are signs of pain becoming more prevalent, based on certain triggers? As you care for the dementia patient, truly observe their behavior and any changes in mood.

• Step Two — If the individual has expressed that they’re in pain, acknowledge that. Reassure them that you will help them find relief. If they cannot communicate effectively, based on your observations, treat the cause. Could they be suffering from something as simple as a cavity? Are they constipated, causing stomach pain? When you are able to find the root cause of one’s pain, this will be a significant breakthrough.

• Step Three — Increase comfort levels, especially for those that suffer from conditions like arthritis. In these cases, regular massages or cold therapy can help relieve pain, inflammation and tension.

• Step Four — Reassess current medications to ensure they’re still needed. The truth is, there are some medications that are no longer needed, yet patients continue to take them. In some cases, this may lead to side effects that promote pain. When taking anti-inflammatory drugs or even OTC painkillers, please discuss any changes with the patient’s physician.

• Step Five — On that note, you may also want to reduce the number of procedures or treatments that provide very little benefit to the patient’s overall health. Although it’s important to monitor one’s health, regular blood tests and other invasive procedures may not be necessary.

• Step Six — Near the end of one’s life, it’s often best to ensure optimal comfort. You will want them to be free of distress, here are some top ways to manage stress so in this case, a palliative care team may be your best solution.

Using Ginseng And Bacopa Monnieri

As long as herbal remedies do not interact with any critical medications, they are most certainly worth trying. Depending on the source of one’s pain, there are certain foods and exercises that can be implemented into one’s daily routine. Two options, that are often used to treat vascular dementia, can also address pain:

1. Ginseng — Used for centuries in Chinese medicine, Panax ginseng is known to treat hypertension, pain, and even atherosclerosis. It has also been shown to improve cognitive function in both healthy participants and Alzheimer’s patients.

2. Bacopa Monnieri — Traditionally used within Ayurvedic medicine, this herbal remedy is used to treat inflammation, memory decline, pain, asthma, and fever.

 The takeaway here is that there ARE options available. It’s important to explore all possible avenues, focusing on the root cause of one’s pain. For more information and a list of resources, please visit Geriatric Pain.

References

http://www.pssru.ac.uk/pdf/MCpdfs/Pain_factsheet.pdf https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3817007/