They're not able to verbally express or rate their pain or discomfort. This isn't an option for patients with moderate to severe dementia. Patients often are asked to rate their pain on a scale of 1 to 10. This can lead to social, spiritual or emotional pain, which is felt physically like other types of pain. Patients may experience significant loss or grief, even when confused or disoriented. And patients have a hard time expressing nuanced symptoms like chest or flank pain.įinally, mental pain can be exasperated by dementia. Swelling or other symptoms may not be easily noticed if the person is bedridden.
Caregivers may not realize the disease has worsened because patients cannot verbally express how they are feeling. These types of pain can be more difficult to assess. Other medical conditions, like cancer, heart disease or kidney disease, can cause pain. Pressure ulcers can develop from spending a significant amount of time in the same position and lead to pain. This can contribute to developing contractures, which is the tightening of muscle, skin, tendons and tissues. The patient may avoid being repositioned or using painful body parts. Joints can become stiff and sore when not used regularly. These former injuries or conditions can become painful as patients become less mobile. Perhaps the patient had a knee or hip replacement or a tennis elbow injury when younger. Other causes of pain include previous injuries and areas of surgery. This is likely due to the neuroinflammation in the brain. This means that a patient that does not have another apparent known cause of pain could still be experiencing significant pain. The degree of cognitive decline in a patient with Alzheimer's can be directly correlated with the severity of pain experienced. As this messenger is released, it causes the pain-relaying cells in the brain to become inflamed. The changes occur in the area called locus coeruleus and affect a chemical messenger called norepinephrine. The link between chronic pain and Alzheimer's disease is widely accepted despite not being fully understood.Ĭhronic pain affects some of the same areas of the brain that are affected by Alzheimer's disease. It is associated with cognitive, emotional and social decline. Types of dementia-related painĬhronic pain is pain that lasts longer than three months. Importantly, there is a marked increase in caregiver stress in those caring for patients experiencing pain. Patients may become more alert and interactive once their pain is treated, even if medications have a possible side effect of drowsiness. Even though patients may feel drowsy and sleep more than before, their sleep is disturbed and not restorative. This may be due to their discomfort or lack of solid sleep. Untreated pain also may cause patients to become more withdrawn or fatigued. These include screaming, cursing or striking out, particularly at caregivers. Unfortunately, many patients with dementia are left with only basic expressions of pain presented through negative behaviors. Also, patients may have lost the cognitive ability to tell caregivers about their pain with phrases such as "this hurts" or "I am in pain." This minimizes typical facial expressions of pain, like a drawn mouth or furrowed brows. Alzheimer's disease causes the person to develop a mask-like facial expression. Many patients receive inadequate treatment due lack of recognition. Between 50% and 80% of patients with moderate to severe dementia experience pain daily. Dementia-related painĪs dementia progresses, so does the likelihood that patients are experiencing pain. Pain is another frequent symptom, although it is often overlooked and undertreated. Other common symptoms are physical functional decline and difficulty with mental tasks, like planning or spatial ability. There is a constellation of dementia symptoms, and memory loss is the primary feature. Dementia is the seventh leading cause of death worldwide. Of these, 50% to 60% have Alzheimer's disease. There are more than 55 million people worldwide living with dementia. Instead, it describes a collection of symptoms that affect a person's thinking and social abilities enough to interfere with daily life.
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