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Solving the Pain-Puzzle in Those with Dementia


working with someone who may have dementia

It isn’t always easy to recognize when an elderly, cognitively impaired person is in pain. Those with dementia can’t always tell you they have a toothache, or even remember how they got hurt in the first place. However, anyone can become a better pain detective when they know what to watch for.


A change in facial expression is often a first indicator. Is the person grimacing? Are they wearing a slight frown or sad looking face? A distorted expression or sudden rapid blinking can be indicators of pain.


Verbalizing or making unusual sounds can indicate pain. Listen for heavy sighs or moans and groans. Sudden calling out or verbally abusive outbursts can be puzzling behaviors but they are sometimes the only way a demented person can express their pain.


From obvious gait or mobility problems, to rocking back and forth, these new or unusual body movements may be the only way they can tell you that they are in pain. Watch for increased fidgeting or pacing. Body language is an important communicating device.


Pattern changes in daily activities is an indicator of pain. If their appetite decreases, or if they want to sleep all the time, they may be in chronic pain.


Unfortunately, dementia itself comes with the risk of developing a painful condition, due to decreased mobility as the major culprit. First, there is the increased risk of accidents and falls, but lack of mobility can also lead to problems such as: constipation, joint stiffness, pressure sores, and even contractures (muscles and joints that have shortened and tightened.)


Since detecting pain in a person with dementia isn’t always easy, you might opt for a more proactive approach to dealing with possible painful conditions. Follow these simple but effective steps to keep your loved ones pain-free:


Change a person’s position often to prevent rubbing or pressure points.


To prevent sore joints and muscles, encourage movement of arms and legs. A physiotherapist or occupational therapist can offer an easy to follow daily routine.


Apply body lotion regularly. Dry, chapped skin can be painful and skin breakdowns that produce open wounds carry the added risk of infection.


Our bodies need water. Proper hydration can prevent headaches, while improving digestion and lowering the possibility of bladder infections.


Learn safe methods of moving someone in bed or helping them to stand from sitting. This way you won’t risk hurting yourself, or the person you are caring for.


Whether you suspect a loved one with dementia is dealing with a painful condition, or your goals are to prevent pain from ever rearing its ugly head, know that your efforts to solve their pain puzzle is appreciated.

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