As our bodies age, there are changes due to the wear and tear of life on our joints, our organs, and our tissue. Skin wrinkles and gray or white hair are external signs of aging. However, we cannot see the internal changes with aging. As a senior with pain who does not have impaired thinking, I can speak to my healthcare provider about my pain, the site of the pain, the intensity of the pain, the onset of the pain and the manifestation of the pain. When one has dementia, how do we secure this information? Because one cannot tell about the pain, does not mean that it does not exist.
Those with dementia have pain. Because they cannot tell us about it, does not mean that it does not exist for them or that the experience of pain is any less distressing. The problem is that they are not able to tell anyone what they are experiencing. So what do we do? We watch for nonverbal and behavioral indicators of the pain. Some of the ways we observe this are:
The most important thing is observation. When the family or caregiver sees a difference in the way the senior moves or participates, this is a strong indicator that something is amiss. This change is frequently a way that pain is demonstrated
Always talk to your healthcare provider before starting any pain regimen. There may be drug interactions or side effects that are not described in the lay literature. The brain of the senior with dementia is no longer functioning properly, and medications can worsen the symptoms related to memory loss.
One of the most difficult challenges is providing therapeutic modalities to those who cannot speak to us and tell us about their symptoms. Remember, we are the advocates and must be constantly vigilant to intervene when there are issues that cannot be shared due to memory impairment.