Dementia & Pain

DesperateofDevon

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Jul 7, 2019
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So to keep it brief when Mum was at home & in pain an opioid patch wasn’t suitable as it enhanced the falls risk. Now mums in care she’s so far down the dementia path that she can’t express pain & the new GP says a pain patch isn’t required.
Have provided all medical evidence of osteoporosis & degenerative conditions but still the answer is no

Mum can’t swallow solids & is at EOL , so no pain relief but a morphine driver etc ready when deemed necessary.

I can no longer keep presenting evidence for it to be ignored, I have to walk away. Why given all evidence is pain relief not given ?

no one should be in pain
 

canary

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Feb 25, 2014
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South coast
What do the nurses in the nursing home think?
They are more used to seeing people in pain and are better at recognising it.
 

DesperateofDevon

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Jul 7, 2019
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The nurses say mum doesn’t vocalise it , but as she’s unable to communicate verbally & facial expressions are now so frozen they have only the past two weeks to go on.
Medical evidence states pain historically & Mum pushes folks away for PC & waves an arm .

I cannot keep pushing for pain relief anymore - it’s ridiculous that frontal lobe & vascular dementia is not understood by so many.

The palliative care was prescribed at hospital & not implemented , have given all documentation we have to care home; but hospital discharge states otherwise for pain.
 

lemonbalm

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May 21, 2018
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My Mum was given Oramorph during the last few weeks of her life. The carers syringed it into her mouth very slowly at the end when she was unable to swallow. Mum was so tiny by then, the doctor felt the pain patch was too much for her but was happy for the Oramorph to be given in the morning (before any personal care) and again early evening. That may be worth suggesting to the nurses.
 

DesperateofDevon

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Jul 7, 2019
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My Mum was given Oramorph during the last few weeks of her life. The carers syringed it into her mouth very slowly at the end when she was unable to swallow. Mum was so tiny by then, the doctor felt the pain patch was too much for her but was happy for the Oramorph to be given in the morning (before any personal care) and again early evening. That may be worth suggesting to the nurses.
Have asked but as Mum refuses liquid pain relief on a daily basis it’s a patch that is needed. I do understand that Mum is so frail & under 6 stone but i hate to think of her in pain & unable to express that anymore.
I am at a loss now as to how to proceed & have to accept that I cannot solve this issue. That’s the hardest part in all of this , having fought for every single aspect of care to not ensure someone is pain free seems inhumane as surely it’s a basic right ?
 

DesperateofDevon

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Jul 7, 2019
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So I’ve stepped away , as I obviously interpret Mums facial grimaces differently …or she only does it when I am there ?
 

Jaded'n'faded

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Jan 23, 2019
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High Peak
Surely anyone at end of life deserves a bit of morphine? Whether your mum feels pain or fear, a few morphine dreams would ease those feelings.

Do these people have no humanity? What harm could it possibly do at this stage?
 

canary

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Feb 25, 2014
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South coast
So I’ve stepped away , as I obviously interpret Mums facial grimaces differently …or she only does it when I am there ?
Do you ever see your mum smile?
The reason Im asking is because at stage 7 in the 7 stages of dementia, one of the things that happens is that they lose the ability to smile and when they try it looks like a grimace.
Im not saying that this is what you are seeing - Im just offering it up as a possibility
 

Violet Jane

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Aug 23, 2021
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I’ve said similar to the #7 post in another thread. It’s to do with Shipman, the pusillanimity of the medical profession and, probably, the composition of the HoL. It’s better to let someone slowly starve to death and for his/her body to be slowly poisoned through dehydration than to give him/her a merciful ending.
 

Violet Jane

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Aug 23, 2021
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Yes, they are dying but little sips of water / yoghurt etc now and again just prolong the dying process unnecessarily. If people have to go right to the bitter end then at least morphine would calm them and ease any suffering. We don’t let animals die in this way so why do we accept it for humans? If it’s cruel for animals then it’s cruel for humans. And a doctor told me quite recently that when she was a young doctor people were helped on their way at the very end of their lives and this was thought the right and humane thing to do. We seem to have gone backwards.
 

Canadian Joanne

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Apr 8, 2005
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Toronto, Canada
@Violet Jane @canary is correct. When a person is dying, they will not take in food or fluids. When my mother was dying, the first few days she was being hydrated by IV, until it was evident that she was dying. There is not dying of starvation or dehydration.

However, my mother did receive morphine injections just in case she was feeling any pain.
 

Canadian Joanne

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Apr 8, 2005
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Toronto, Canada
@Violet Jane I cross-posted. My mother would not swallow anything for 6 days before she died. I don't think a few sips of water or yogurt would make a difference, even if the person could swallow them.

I think the reason we accept this for humans is that 'helping someone on' is a slippery slope. Who gets to decide? I wouldn't want medical personnel deciding on such a course. I personally could not have agreed to my mother being helped along. She did not appear to be in distress but even so, I couldn't have done it.

There is a difference in allowing nature take its course and actively doing something to enable someone to die. It's a very difficult questions altogether.
 

jennifer1967

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Mar 15, 2020
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Southampton
sounds like you are talking about euthanasia. there was a case of a doctor doing that in a hospital and she was struck off for using inappropriate amounts to speed the process up.
my nan chose herself not to eat or drink or take fluids including iv drip[she pulled it out]. to my knowledge she was not given morphine but was given a sedative when she became distressed. you have to be so careful the way you express yourself. @canary and @Canadian Joanne are very knowledgeable about the processes and ive learnt so much from their real life experiences