Last Night’s crisis - Ideas Welcome

[FuzzyDuck]

I’m visiting my folks (dad caring for mum who has Alzheimer’s). Unfortunately mum is not having a good time. On Sunday night / Monday morning she was crying in pain according to dad. Monday night passed quietly (some crying with pain at about 6:00) but it settled down. Tuesday evening was similar. Tears around 6:00 due to pain in her tummy but settling down. Unfortunately at 3:30 am mum was screaming with tummy pain and wanting to die. An ambulance was called.

Mum was examined, blood, urine tests before being given morphine and being discharged.

Mum has been complaining of intense abdominal pain for at least 6 months. She’s had all sorts of tests (US scans, MRIs, etc) and nothing has been found. Three or four different doctors believe the pain to be an Alzheimer’s manifestation.

Mum takes paracetamol for her pain normally. She can be distracted from the pain (something I have learned today). To her, the pain is very real. She is screaming with it. The more I think about it, the more I think it’s psychosomatic. It’s linked with her mood. The happier and more content she is, the less pain she suffers.

Today, after the return from hospital, we discussed cancelling their Christmas holiday. They are due to go on a cruise and dad feared a medical evacuation would be needed if mum suffered the pain she suffered last night. As they would be travelling with my mum suffering a known condition he was concerned the travel insurance would fail to pay and he could be left with a colossal bill.

Mum was initially very upset and angry about the prospect of missing out on her holiday but eventually agreed, reluctantly that the holiday should be cancelled.

They went to the doctors to discuss how to continue with this intense pain issue and to get a certificate stating she isn’t fit to travel on the holiday so the insurance will cover the payment. The doctor however prescribed morphine as a “just in case” solution for mum’s pain and declared her fit enough to travel.

This made mum happy and since returning she’s been much more animated and chatty. No complaints of pain, although if anyone asks - it’s always there.

Does anyone else have experience of dementia sufferers experiencing pain where there is no physical explanation? Any tips on this point most welcome.

 

[Cazzita]

No, my mum hasn't experienced anything like that so far. Someone might have knowledge of this and will let you know. How strange is the human body and mind...
Good luck and let us know how you go x

 

[Splashing About]

My mum’s disease has had different phases. One of those could be described as the hypochondriac phase. However I don’t think she consciously claimed ill health but there was an underlying anxiety in her that she eased by developing symptom after symptom. She had every investigation under the sun....when nothing was found and she’d exhausted the investigative process the illness mysteriously went away. A short while later a new one developed. And repeat.
I think she visited nearly every dept in the hospital apart from neurology.

My advice would be distraction, placebos etc. That sounds a bit devious but if she has been medically checked out I think that is worth a try?

 

[Bod]

How much Morphine has been given, and over how long?
Could she be addicted to it?
Same question for Codeine(including Co-Codamol and similar over the counter meds)?

Bod

 

[Champers]

My mum’s disease has had different phases. One of those could be described as the hypochondriac phase. However I don’t think she consciously claimed ill health but there was an underlying anxiety in her that she eased by developing symptom after symptom. She had every investigation under the sun....when nothing was found and she’d exhausted the investigative process the illness mysteriously went away. A short while later a new one developed. And repeat.
I think she visited nearly every dept in the hospital apart from neurology.

My advice would be distraction, placebos etc. That sounds a bit devious but if she has been medically checked out I think that is worth a try?

I think you’re right, Splashing About. A form of hypochondria may well be a little known phase of some dementia suffers. Possibly, they know something is wrong, but are unable to be specific so use general symptoms in an attempt to draw attention to their suffering - a cry for help?

When my mother was in her own home, ever single time I rang her, she would complain of a variety of physical symptoms, particularly severe pain in her legs that she was entirely focussed on - incidentally, now she’s in a CH they’ve disappeared completely! The difference is that she would be in tears with the apparent discomfort, but would not even consider the option of me calling a doctor or taking pain killers.

 

[FuzzyDuck]

My mum’s disease has had different phases. One of those could be described as the hypochondriac phase. However I don’t think she consciously claimed ill health but there was an underlying anxiety in her that she eased by developing symptom after symptom. She had every investigation under the sun....when nothing was found and she’d exhausted the investigative process the illness mysteriously went away. A short while later a new one developed. And repeat.
I think she visited nearly every dept in the hospital apart from neurology.

My advice would be distraction, placebos etc. That sounds a bit devious but if she has been medically checked out I think that is worth a try?

This is what I think at the mo. If we can distract or use a more innocuous painkiller like asprin or indeed a placebo, this is a better way to go. I also think keeping mum busy and distracted is also important.

It is difficult though. This trip is my first time seeing her with the pain her and dad have been talking about on the phone. To mum it is very real. She is screaming in agony, which is obviously distressing for anyone present. Hopefully distraction before we get to the screaming in agony stage will work.

 

[Sirena]

My mother went through a hypochondriac phase, it seems to be quite common. I think it's part of a generalised anxiety. She had two A&E admissions for 'heart problems' (indigestion) and multiple GP/specialist visits for 'lung cancer' (a cough caused by an allergy). So I suspect your mother has a slight tummy problem, could be anything - indigestion, reflux, muscle spasm - and she over-interprets this as "I'm in agony, call an ambulance". People with dementia seem unable to differentiate between discomfort and extreme pain.

 

[FuzzyDuck]

How much Morphine has been given, and over how long?
Could she be addicted to it?
Same question for Codeine(including Co-Codamol and similar over the counter meds)?

Bod

The morphine is very much prescribed as a last resort if mum does get this severe pain. The idea is that the morphine is used as a one-off to get the severe situation quickly under control. The morphine should then not be used again until the next time the situation got severe.

That said, it is morphine. I was surprised the doctor prescribed it even in this “just in case” scenario. Morphine, to me, is not something to throw at pain that has no physical cause.

Dad understands the dangers of morphine but I am making it clear to him that the morphine is for when all else fails.

 

[FuzzyDuck]

My mother went through a hypochondriac phase, it seems to be quite common. I think it's part of a generalised anxiety. She had two A&E admissions for 'heart problems' (indigestion) and multiple GP/specialist visits for 'lung cancer' (a cough caused by an allergy). So I suspect your mother has a slight tummy problem, could be anything - indigestion, reflux, muscle spasm - and she over-interprets this as "I'm in agony, call an ambulance". People with dementia seem unable to differentiate between discomfort and extreme pain.

Indeed Serena. I even thought it could be hunger pains as, while I was here the initial pain came at the same time in the evening on two consecutive evenings. Once we’d been out and got something to eat, the pain subsided (at least she wasn’t crying with it). That theory was shot up when mum was screaming in agony on Tuesday night however.

 

[Louise7]

Could it be constipation? Are her bowels 'regular'?

 

[Bunpoots]

Could it be trapped wind? I know this is really really painful as I get it occasionally - and it's known for making infants cry with pain!

The only thing that works for me is bisodol tablets... or gripe water ...none of the other antacids touch it.

 

[Lawson58]

My husband complained for about a year about feeling bloated and having a lot of abdominal discomfort. He had initial x-rays, scans, all sorts of tests which showed some mild constipation at the time but nothing else.

He was convinced that he had cancer and no amount of reassurance from our GP would change his mind.

I worked hard to deal with the constipation and as everything settled down so has his complaining about his discomfort.

I am not saying that your mum has constipation, just that whatever is bothering her may be exacerbated by her inability to deal with her fear (resulting from her dementia) and her pain, with her ending up in a genuine state of panic.

 

[canary]

My MIL (vascular demantia) used to phone up in the evening telling us that she felt so poorly and was in pain. This pain used to change daily, so it wasnt always in the same place, but it was always in the evening that she phoned. Im sure she was sundowning and knew something was not right, but didnt know what, so she would fixate on any tiny feeling of discomfort.

 

[FuzzyDuck]

Could it be constipation? Are her bowels 'regular'?

Could it be constipation? Are her bowels 'regular'?

No - she’s regular enough

 

[FuzzyDuck]

Could it be trapped wind? I know this is really really painful as I get it occasionally - and it's known for making infants cry with pain!

The only thing that works for me is bisodol tablets... or gripe water ...none of the other antacids touch it.

Don’t think so, but I agree, trapped wind is painful

 

[FuzzyDuck]

My MIL (vascular demantia) used to phone up in the evening telling us that she felt so poorly and was in pain. This pain used to change daily, so it wasnt always in the same place, but it was always in the evening that she phoned. Im sure she was sundowning and knew something was not right, but didnt know what, so she would fixate on any tiny feeling of discomfort.

Mum is at least consistent in where the pain is. Always lower abdomen. When severe that can escalate to an imprecise “everything hurts”. But yes, there is certainly a bit of making a meal of small discomforts but that is different from the major tummy ache.

 

[MaNaAk]

Other people have offered good advice but I want to say how I feel for you and your poor parents living with this. I no you say your mum is disappointed but your poor dad must be beside himself.
Please give him plenty of hugs.

MaNaAk

 

[FuzzyDuck]

Other people have offered good advice but I want to say how I feel for you and your poor parents living with this. I no you say your mum is disappointed but your poor dad must be beside himself.
Please give him plenty of hugs.

MaNaAk

Hi MaNaAk

My Dad is who I have the most concern for. Unfortunately both my brother and I live a long way from them both so are more limited than we would like to be in the support we can give. Dad puts up with so much and needs more support. Unfortunately, he has been pushing away support in all sorts of ways (see a previous thread on about my proud dad).

He does need hugs and much much more. This is an awful illness but, although sometimes it might not seem like it, improvements can be made in the way we all live with it. Let’s hope we all find them.

thanks for the support.