Knowing how to help patients in pain is one of the most important functions in a care home, and it is not always easy. This can be difficult at any time, and it is even more so when patients are suffering from dementia. They may not always be able to communicate how they are feeling effectively. There is also a common belief that these patients may not be experiencing pain in the same way as other people.
Assisted living facilities like hospices and nursing homes should be able to manage the pain of a dementia patient. If the stage of the disease is advanced, the sufferer shouldn’t remain at home. Caregivers can understand the pain, but they’re not experienced enough to diminish it. Nursing homes provide the highest level of comfort for those with dementia. They’re being attended 24/7 and they’re being offered daily activities to help them cope with the disease. A licensed staff will supervise all patients to make sure all their needs are being catered for. Here are some ideas on how care homes can identify and manage pain for dementia patients.
Identification and assessment
Difficulties with cognitive processes and communication can make it hard to properly identify pain conditions in dementia patients. When staffs at the care home are overworked or lack adequate awareness or training, that can also be an issue for identification and assessment.
Getting the diagnosis correct is critical, in order to determine the correct treatment for the problem. There are methods that can assist in this process, including the Abbey Pain Scale, which is a useful tool when patients have serious cognitive impairment.
Another tool is the Resident’s Verbal Brief Pain Inventory. This one is a more useful tool for people who have a greater level of cognitive ability. To evaluate the on-going intensity of pain, and gauge how a person is responding to treatment, good tools include the Verbal Descriptor Scale and the Numeric Rating Scale.
Effective assessment and management of pain requires collaboration between all of the health care professionals and care givers involved, including nurses, doctors, physiotherapists, and other staff members.
All medications to be prescribed must be considered in light of other existing medical conditions. The patient may have other symptoms that need to be managed as well, such as insomnia, constipation, anxiety, or depression. In complicated or difficult cases, it may be advisable to refer the case to a pain specialist.
Cognitive-behavioral therapy can be useful for patients who have behavioral issues that are related to their pain, such as sleeplessness or overuse of medications. Cognitive-behavioral therapy can also be useful for those patients who have emotional issues related to their persistent pain, such as depression or anxiety.
This type of psychological approach can yield other benefits as well. Many patients have shown an overall improvement in their quality of life, with greater social engagement, improved coping skills, and lower rates of anxiety, depression, and mood swings.
Physical therapy approaches
Physical therapy can be used to lessen pain. Specifics will depend on the patient’s physical abilities, as well as their ability to understand and communicate. Physical therapy could include aerobic exercises, strengthening exercises, isotonic exercises, or other exercises based on their abilities and needs. TENS therapy (Transcutaneous Electrical Nerve Stimulation) can also be considered as an alternative for managing persistent pain.
Alternative therapy approaches
- Massage is one approach that can be used together with traditional pharmacological approaches to achieve greater pain relief
- Using multiple practitioners requires excellent communication between them, to make sure that different treatments complement each other rather than conflicting with each other.
- Main health care providers should always be consulted before any additional therapy approach is begun
Managing pain in dementia patients can only be done by professionals in the medical field. Not everyone can afford to live in an assisted living facility though. At home care is possible, yet the caregiver should have extensive experience. Understanding the source of the pain is the first step; watch out for facial expressions and when in doubt it’s always best to ask an experienced physician. At home caregivers without medical background are not allowed to administer powerful drugs. Hiring a registered nurse or a licensed practitioner to look after a loved one with dementia is also a viable alternative you should consider.