How Can a Pain Management Specialist Help Seniors With Dementia?

As you grow older, chronic pains and diseases might become an inevitable part of living. While it can be difficult to cope with aches, soreness, and tenderness, pain management specialists can help provide you with the skills and therapies necessary to lead a fulfilling life. Pain management specialists are licensed professionals who are concerned about their patient’s ability to function and their quality of life. Pain management specialists can be helpful at any point in your life, but they’re especially helpful for seniors, and those with Alzheimer’s or dementia. If your loved one seems to be struggling with chronic pains that aren’t being alleviated by traditional means, a pain management specialist might make all the difference.

What Does a Pain Management Specialist Do?

There are many different types of pain specialists, and not all of them work with physical pain. Some of the different pain management specialists include:

• Occupational Therapists
• Physical Therapists
• Pain Management and Rehabilitation Specialists (PM&R)
• Psychologists

They are most concerned about the overall quality of life for their patients, so for that reason, they generally won’t just focus on a single area of the body.

Diagnosis

Before they can start introducing therapy for alleviating the pain, a specialist must first diagnose the cause of pain. For acute injuries this can be clear, as it’s often related to a specific injury at a point in time. But for chronic conditions, the cause of discomfort can be more elusive. Pain management specialists rely on medical history, physical and neurological examinations, as well as the patient’s own input. For people with dementia who may not be able to clearly communicate their feelings, specialists may look for other signs of discomfort. Some questions that might be asked by a specialist during the first session might include:

• Where is your pain?
• What does the pain feel like?
• When do you feel pain most often?
• Does anything make the pain worse? 
• What makes the pain feel better?
• How often do you feel pain?

Additionally, a pain management doctor might order diagnostic studies, like X-rays, MRI scans, or CAT scans to help them assess what’s going on.

Treatment

Once the cause of pain has been discovered, the specialist can look towards treatment methods to help provide more comfort. Typically, the first line of treatment incorporates non-pharmacological treatments, such as physical therapy. However, medications can be prescribed when necessary to help soothe discomfort. Usually, a combination of both are most effective. There are many possible therapies for alleviating pain, including:

• Non-narcotic pain relievers
• Topical medications
• Exercise programs
• Physical therapy
• Electrical stimulation
• Interventional treatments
• Medications targeting pain

Pain and Dementia

Dementia is a general term for loss of memory, cognition, and language that are severe enough to interfere with daily life. Alzheimer’s disease accounts for 60 to 80 percent of cases.  Clearly communicating pain and being able to accurately describe it is critical to pain management. For example, if you have a shooting pain in the back of your neck, being able to express this to a doctor and describing where exactly it is and what makes it better or worse can help them get a better idea of what’s wrong. With individuals who have dementia, this becomes tricky, as communication can be much more difficult. When a patient with dementia is unable to alert others to the location and severity of the pain on their body, it can lead to misdiagnosis or poor quality of life.   Over half of people with dementia experience daily pain, further cementing the importance of a pain management specialist. They are trained to see some of the less inherent signs of physical discomfort in seniors who may no longer be able to communicate in traditional ways. This can be essential for making sure that your loved one is living the healthiest and happiest life possible.

How Do Pain Management Specialists Diagnose Pain in Persons with Dementia?

The best way to diagnose and assess pain is with self-report, either through personal interviews or pain scales. Although people with dementia may not be able to self-monitor internal symptoms appropriately, it should not be discarded too quickly. For persons with dementia, it can be helpful to use more simplistic methods, such as using numerical scales to rate pain (1-5) or simple categorical questions (answering with a lot, a little, or not at all, for example).  With that said, even the most simplistic categorical tools can prove ineffective for those in later stages of dementia. For that reason, observer tools are often used in conjunction. Observer tools allow the pain management specialist to observe physical characteristics which may alert them to an individual’s sensation of pain. This is usually assessed through three domains: facial responses, vocalization, and body language. For persons with dementia, there are also some tendencies and behaviors that may make it apparent that an individual is feeling discomfort. For example, some people with dementia may say “I want to go home” when they are in a situation where they feel stressed. Pain management specialists must be aware of the deeper meanings behind the behaviors and motivations of persons with dementia, which emphasizes the importance of practicing in an interdisciplinary setting where many specialists can work together to provide the best care possible.

Who May Benefit From Pain Management?

Anyone who experiences chronic pain can benefit from pain management. You should try getting your pain assessed and managed before it becomes too severe, meaning that you’ll want to seek help if the pain persists for a few days without getting any better in case the pain is being caused by something that’s doing damage to your joints or muscles.  Some of the most common conditions where pain can be relieved even temporarily with these types of interventional programs include:

• Rheumatoid arthritis
• Osteoarthritis
• Neuropathy
• Fibromyalgia
• Degenerative disc disease
• Herniated disc

But pain management doesn’t just benefit those who are directly experiencing pain. It can also bring a lot of peace of mind to their loved ones who can be confident that their loved ones are living the most comfortable life possible.

Geriatric Psychology

Pain management doesn’t stop at alleviating physical aches and pains. Especially for people with dementia, there can be a lot of stress, anxiety, and poor mental health. Assessing mental health conditions is just as important as assessing chronic pain in elderly individuals. Physical health is often the focus of most health care providers despite the fact that behavioral health and wellness is equally important. Seniors with anxiety and depression may be less likely to reach out for help, and for those with dementia, it might be impossible to communicate these kinds of feelings. The job of a pain management specialist focusing on behavioral health is the same as those focusing on physical ailments. Treatment might include talk therapy, if applicable, or psychiatric medication to help improve quality of life. Conditions that can be treated or managed with geriatric psychology include:

• Anxiety
• Depression
• Bipolar disorder
• Obsessive-compulsive disorder
• Post-traumatic stress disorder
• Schizophrenia
• Dementia

Managing mental health can even have positive effects on physical wellbeing. Chronic pain can cause a lot of stress, and stress can make chronic pain worse. If the mental effects of chronic pain can be addressed, it might have positive effects holistically.

Preventing Pain

Pain management specialists won’t just treat existing pain, they’ll also do whatever they can to help prevent pain from returning following treatment. This includes incorporating a daily routine of exercising, eating proper nutrition, and avoiding activities that might cause a painful flare-up. Additionally, you’ll incorporate tactics that involve managing stress, increasing strength and flexibility, and practicing healthy habits overall.

In Conclusion

Pain management specialists focus on improving their patient’s quality of life by diagnosing and treating the root cause of pain. This is very important for senior populations who experience chronic pain. Effectively diagnosing the root cause of pain involves self-reports such as answering questions and communicating with a doctor the severity and location of sensations. However, for people with dementia who cannot do this effectively, observational reports and other methods must be used. For persons with dementia, pain specialists might use more simplistic observation methods, such as asking yes or no questions or examining body language. Since over half of people with dementia experience chronic pain, this is imperative for their quality of life. Most healthcare providers only focus on physical health, but behavioral health is just as important. Helping to manage the stress and anxiety of mental conditions can have direct benefits on physical complications. At Lightyear Health, we understand the value of comprehensive care in all aspects of life. Our team of physician-led physical medicine and rehab specialists work to alleviate physical pain while collaborating with behavioral health experts. It’s all-around care that will bring comfort to you and your loved ones.  Click here to learn how to get started.   Sources: What is Dementia? Symptoms, Causes & Treatment | Alzheimer’s Association Pain in dementia | NCBI Chronic Pain and Chronic Stress: Two Sides of the Same Coin? | NCBI