Effective Pain Management Strategies for Dementia Patients
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Seniors with dementia undergo numerous cognitive changes throughout their diagnosis and treatment, including memory decline, behavioural issues, and trouble communicating. A common concern among caregivers is, do dementia patients feel pain?
According to a PAIN Reports study, more than half of the individuals with dementia experience daily pain. Some causes for the pain include musculoskeletal, gastrointestinal, and cardiac conditions and genitourinary infections and wounds, such as pressure ulcers. Some of the pains are chronic, but there is no direct link between chronic pain and dementia for each type of pain or discomfort.
The key to helping your loved one with dementia and pain is getting to its root cause. This requires both dementia and pain assessment to identify the form of dementia and understand if the symptoms are linked to pain. At Sagecare dementia care homes, our registered nurses have deep knowledge about dementia and pain, allowing them to offer the right treatment for your loved one to enhance their health.
Use this guide to understand the correlation between pain and dementia and practical strategies to help your loved one stay comfortable and safe.
Common Causes of Pain in Dementia
Seniors with dementia may experience pain for different reasons. It's essential to observe the signs and symptoms of pain in dementia patients to determine its cause.
Osteoarthritis
Many seniors experience pain in the joints of the upper and lower extremities, especially hips, knees, and hands, due to the degenerative changes of osteoarthritis. This negatively impacts their musculoskeletal health and causes chronic pain. Musculoskeletal health refers to the performance of the locomotor system, which includes the body's intact bones, muscles, joints, and connective tissues. Chronic pain and dementia often go hand in hand, as many seniors with dementia cannot be physically active as they were before their diagnosis.
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Gastrointestinal Diseases
Gastrointestinal conditions are disorders of the digestive system that break down food to absorb water and extract nutrients, minerals, and vitamins for the body's use and remove unabsorbed waste. Digestive disorders vary for everyone based on their condition, but common symptoms include bloating, cramps, vomiting and nausea, acid reflux, constipation, unintentional weight loss, and loss of appetite.
Gastrointestinal diseases can affect many seniors with dementia due to changes in their diet, lifestyle habits, medication, and underlying health conditions. However, some gastrointestinal diseases can progress to forms of dementia, such as Alzheimer's Disease. An Edith Cowan University study found that people with gut disorders may be at greater risk of developing Alzheimer's Disease, and a common link could be cholesterol. Abnormal cholesterol levels were shown to be a risk for Alzheimer's and gut disorders.
Cardiac Conditions
One of the most common conditions that link dementia and pain is related to the heart. Cardiac conditions, such as blood vessel disease, irregular heartbeats (arrhythmias), and high blood pressure, can contribute to dementia risk. For instance, a heart attack increases the risk of having blood vessel problems in the brain. The brain damage that occurs due to an attack or stroke may increase the risk of dementia.
If a senior has heart problems and dementia, they are likely to experience pain sometimes. It's important to prioritize pain in dementia recognition and treatment to reduce other health risks.
How to Identify Pain in Dementia
Some seniors with dementia experience pain when moving, while others may feel pain when they aren't active. It's important to look into an individual's stage of dementia and pain tolerance to find effective solutions. Here are some ways you can start spotting symptoms of dementia in your loved one.
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Use Tested Tool for Pain Assessment
It can be challenging to dig deep into pain in dementia recognition and treatment if your loved one cannot communicate their thoughts. The best way to help them during this time is by consulting a medical professional or using a tested tool for dementia and pain assessment. These tools typically recommend looking out for vocalizations, facial expressions, bodily changes, behavioural changes, and physical changes.
Observe Behaviour
Dementia and pain assessment is crucial for your loved one's health, but it can sometimes be difficult to comprehend the results. If your loved one is displaying signs of pain, continuously monitor their behaviour, as this may help you find the link between their cause of pain and dementia. Watch for signs such as changes when they move, when they are sitting still, or if the pain occurs during certain activities, such as getting dressed or eating.
Treatments for Dementia and Pain
After you have identified signs and symptoms of pain in dementia patients, the next step is to assess the link between the stage of dementia and pain tolerance to find practical solutions. Consider the following strategies for dementia care in seniors experiencing pain.
Prescription Medicine
Dealing with chronic pain and dementia simultaneously can be overwhelming for many seniors. After consulting a doctor to perform dementia and pain assessment, look into prescription medicine for pain relief. The registered nurses at Sagecare know what type of medication can best help a senior with chronic pain and dementia, allowing them to make informed decisions while caring for residents. You can also consult a doctor to determine what type of medicine best suits your loved one based on their health, as you want to avoid mixing too many different medicines.
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Physical Activity
Seniors with dementia can also get relief from pain through physical activity. After assessing an individual's stage of dementia and pain tolerance, our specialized staff can create a comprehensive care plan for dementia patients at our residence. This plan will include exercises that best suit a senior based on their physical abilities, stage of dementia, and pain tolerance.
If you're caring for your loved one at home, seek advice from a physiotherapist on the best and safest techniques to help your loved one stay active.
Distraction from Pain
After dementia and pain assessment, you can offer medication to your loved one and encourage them to be physically active, which are great ways to manage pain. However, if your loved one feels constant pain that affects their sleep or daily activities, it's important to distract them from the pain. This involves encouraging them to socialize, partake in a hobby, and introduce methods to relieve boredom.
Dealing with Dementia and Pain
Watching your loved one struggle with dementia and pain can be challenging, but there are ways you can help them to offer them relief and ease your mind. After you thoroughly understand the causes, symptoms, and treatments for pain and dementia, use the knowledge to provide your loved one with the care they need to thrive.
Melanie Lima-Ribeiro, BScN (Hon), RN
Director of Care
Melanie is a healthcare leader with progressive experience in clinical leadership positions within the Long Term Care, Retirement and ALC sectors. Melanie has always had a passion for seniors as her maternal grandparents played a vital role in her upbringing. Melanie lived with her grandparents until they passed.
At an early age, Melanie realized she enjoyed helping seniors, so at age 15 she started working part-time as a dietary aide in a Long Term Care Home in downtown Toronto. She immediately had a heart for the healthcare sector, especially the geriatrics populations, so she pursued nursing.
Melanie is passionate about resident- and family-centred care. Every individual is unique and their individual needs are unique. Melanie’s leadership skills allow her to build deep relationships with partners in the community and advocate for the well-being of those living with dementia.
