I have recently been working with two residents in our care homes that have been showing signs of agitation and distress. Working closely with their GPs in reviewing their treatments, we have considered the part pain may be playing in their behaviour patterns. As care providers, it is vital we work with all health care professionals to reduce distress in residents living with dementia.
It is important that we, as care givers, recognise the following:
- Pain in advanced dementia is a common symptom
- People with dementia experience pain just as much as anyone else
- Pain in people with dementia is often poorly recognised and undertreated; yet it is not difficult to treat
- Caregivers need to work hard to understand a person’s verbal and non-verbal signs that they are in pain
- Uncontrolled pain can seriously affect a person’s quality of life
Recent researchers from Kings College London, and Norway, speculated that patients experiencing pain who were unable to communicate in the usual way, exhibited certain behaviour patterns.
352 patients with moderate or severe dementia were studied in nursing homes in Norway. Half were given painkillers with every meal, the rest continued with their usual treatments.
Supervised treatment ‘key’
After eight weeks, there was a 17% reduction in agitation symptoms in the group being given painkillers; a greater improvement than would have been expected from treatment with antipsychotics.
The researchers concluded that if a patient’s pain is properly managed, doctors could reduce the number of prescriptions for antipsychotic drugs.
Professor Clive Ballard, one of the report authors and director of research at the Alzheimer’s Society, said the finding was significant: “Simple painkillers… had a very, very substantial impact”
With this in mind the two residents I have been working with have both been given regular paracetamol. One lady is much less distressed and more easily settled by staff caring for her. The other lady has only recently started but is already showing signs of improvement around vocalisation on transfer for sitting to standing. Staff are becoming more aware of looking for factors which may drive behaviour change and the importance of sharing information with other staff members and, most importantly health care professionals, to produce sustained quality outcomes for our residents.