recognising pain in people with dementia

[Angie1970]

Hi

I am trying to find out carers experience of pain management for people with dementia, especially in care homes - do care staff recognise when your loved one is in pain or do you feel you have to battle against a system that sees dementia first instead of physical problems.

I would love to hear your experiences

thanks

 

[garnuft]

I don't think it's particular with dementia.
I think it's a problem with every person who lives with brain anomalies, disease and injuries.

I don't for a second think it's easy for a 'stranger' to recognise the symptoms of pain and the signals that a person gives out, even if you're with a person 24/7/365...you're like a badger, digging for information.

THAT, I think, is the hardest part of caring for a person with reduced capacity...working out the new language.

You spend a lot of time OVER-reacting, because you are afraid that you're mis-reading something and then there will be an occasion where you allowed time to reveal an issue and it will bite you on the bum and haunt you forever....well, until the next time.

But the very next time an issue presents itself...back to the beginning of the guessing game you go.

I give my son and FIL, as I did my mother...paracetamols four times a day, to ease the ache of an uncompliant body.

I would not expect miracles from Care Home workers... even when we LOVE the person we can't supply them.

 

[Raggedrobin]

hi Angie
My Mum is in a nursing home and I have found it a real battle to get the staff to understand how pain might work for my Mum. They will ask her questions like 'are you in pain, so you want a paracetemol?' And they don't understand that she automatically says no. What they need to do is observe if she is a bit grumpy/behaving particularly badly, for example, can be because she is in pain.

I read that article in the RCN nursing journal that said that dementia patients are undermedicated and I think it is so true. Mum has bad, chronic arthritis which causes her a lot of pain but it is invisible and so the staff don't always medicate consistently for pain.

I feel staff need much more training in picking up non verbal signals of discomfort that residents show. A lot of it isn't rocket science, if they have an idea what they are looking for, for example, of mrs so and so is particularly weird one day, to ask themselves, could she be suffering in some way, in pain?

That's my take on it, hope it helps.

 

[Lindy50]

This isn't about a nursing home, but it is about medical and nursing staff. When mum had her third fall recently, an enormous bruise was identified in her back, and a UTI, dehydration etc from blood and urine tests.

I felt she was moving her arm awkwardly, and in fact tending to ignore that arm, and I queried an injury to her elbow. Every doctor, nurse and allied professional we saw for five days, denied there was any problem. Then a nurse did indeed notice mum wincing when they were dressing her. An x-ray showed she had a fracture to her elbow.

Mum didn't ever complain of pain. The clue was in her body language.

Hope this helps.

Lindy

 

[Long-Suffering]

It's not just hard for CH staff to understand when a dementia sufferer is in pain. Me and mum have trouble doing this with dad too. He can still speak, but either can't explain how he feels because he's forgotten the words or else he doesn't understand now if he is ill, for example, he doesn't remember what indigestion is or feels like when he gets it.

We always end up playing it safe and ringing for the ambulance when he gets chest problems (indicated by rubbing his chest, scowling, crying, anger, etc.) and each time it's been nothing serious. But better safe than sorry.

LS

 

[Angie1970]

Thanks for your response, it is really helpful. Do the staff take your views into account when you say you think she is in pain or not? It seems to be a common theme of carers not understanding the signs

Angie

hi Angie
My Mum is in a nursing home and I have found it a real battle to get the staff to understand how pain might work for my Mum. They will ask her questions like 'are you in pain, so you want a paracetemol?' And they don't understand that she automatically says no. What they need to do is observe if she is a bit grumpy/behaving particularly badly, for example, can be because she is in pain.

I read that article in the RCN nursing journal that said that dementia patients are undermedicated and I think it is so true. Mum has bad, chronic arthritis which causes her a lot of pain but it is invisible and so the staff don't always medicate consistently for pain.

I feel staff need much more training in picking up non verbal signals of discomfort that residents show. A lot of it isn't rocket science, if they have an idea what they are looking for, for example, of mrs so and so is particularly weird one day, to ask themselves, could she be suffering in some way, in pain?

That's my take on it, hope it helps.

 

[Angie1970]

Thanks for your response, yes you are right it is a much wider problem and one that needs tackling. Hope mum is ok now.

This isn't about a nursing home, but it is about medical and nursing staff. When mum had her third fall recently, an enormous bruise was identified in her back, and a UTI, dehydration etc from blood and urine tests.

I felt she was moving her arm awkwardly, and in fact tending to ignore that arm, and I queried an injury to her elbow. Every doctor, nurse and allied professional we saw for five days, denied there was any problem. Then a nurse did indeed notice mum wincing when they were dressing her. An x-ray showed she had a fracture to her elbow.

Mum didn't ever complain of pain. The clue was in her body language.

Hope this helps.

Lindy

 

[starryuk]

https://www.youtube.com/watch?v=9kSjHtHSJCw

https://www.youtube.com/watch?v=-na0bx0KGAo

If only some of these 'professionals' would watch some Teepa Snow videos.
These two(part 1 and 2) are about recognizing pain in people with advanced dementia.

 

[Jaxx]

Mum has a pre existing spinal injury which causes her a great deal of pain. She was only diagnosed with Alzheimer's in June this year but one of my worries was how she would tell me she was in pain when her Alzheimer's is so bad she can't communicate.


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