Does dementia affect pain tolerance?

I know what your Mom is going through regarding a broken bone and pain. Recently been there done that. When wearing a restraint one's arm isn't moving thus very little pain, except for trying to sleep.

But once it is time to start using that arm again the pain is very jarring because the muscles in the arm had tightened up due to non-use. Rehab is quite painful as the therapist is pulling/tugging on that arm to stretch the muscles, I went 3x a week for four months, I still need to go back.

Was the broken arm your Mom's primary arm? If yes, that makes it even worse because you are now forced to use your other arm to try to dress, eat, comb your hair, brush your teeth, write, etc. with that outcome that resembled that of a 3 year old. Try doing everything with just your other arm and see how it can be. And you are using muscles that aren't use to doing these things, so that other arm starts to ache.

Even though my break was back in May, my arm still will ache when I try to lift something heavier than a loaf of bread, and/or if the weather is bad. Yes, the pain is real and will be real for quite some time.

Regular massage. Start gentle & gradually go deeper at level tolerated. Always massage before pulling & tugging on arm. If possible excerciser/ stretch in spa or hot water bath. If in bath add bicarbonate of soda. If doc refuses to listen get second appinion (RN)

In my experience, simply observing my mother's plight in enduring sometimes unexplained, transitory twinges of pain, it almost seems as if the more severe her memory loss, the more acute any pain became, even to the point of her becoming nearly inconsolable.Even if given sufficient pain meds, it never seemed to be enough. Neuropathy is one term frequently used in this situation, where the type of dementia is intertwined with nerve dysfunction, described to feel like when our feet "fall asleep' and the pain we feel in their reawakening, but as a constant, unyielding
burn. Medication that inhibits neuro-receptors can sometimes alleviate this, but research shows mixed success. I find that consoling my mom and reminding her that it is not life threatening and that this, too, shall pass, helps more than anything.

I have seen that when my mother is more confused she complains more of pain. Back when my mom was not sleeping and constantly calling out we were considering dilaudid as nothing seemed to ease her discomfort for long, if it wasn't her hips or knees it was a headache. We tried mirtazapine to help her sleep and it was like a miracle drug, not only did she sleep through the night but she was more lucid during the day and her complaints of pain almost disappeared. Recently the problems with sleeping, agitation and pain have been creeping back, so I definitely see there is a connection.

cwillie, did was your mother prescribed both Dilaudid & mirtazapan. Wandering if the pain med has been withheld or ceased now mum's on mirtazapan. If so could be why pain levels are now increasing. May need reviewing

My father has frequent pain in his left arm, and often in his neck. At 98 with a weak heart, health professionals won't prescribe pain medication except Lydocaine pain patches for his lower back which also aches. I am told it would adversely affect his heart.

Has anyone else has similar results?

I meant to ask about similar advice.

Michell, we never started the dilaudid, I was very reluctant to go that route as we already have bowel problems. She gets by now with acetaminophen and ibuprofen.

From what I've observed, the signals can be seriously screwed. There is a woman in the memory care unit with my husband who often seems to exist in her own private hell. He calls her "the crazy one." One day, as her visitors were leaving, she kept repeating, "Please don't leave me." Another time, she was saying this when there was only a staff person nearby. The worst I've heard was a sequence that started with "What did I do?" and segued into "What did I do that was so bad?" After a few minutes of that, it was, "Oh, God. O, God . . . ." She sounds like a soul in torment and is obviously feeling something but it may not be clear to anyone where it is coming from.

If
Mom us taking namenda,, it can cause carpal tunnel . I found that out after doc said he could find anything wrong. I looked at medication side effects and lo and behold... It was there! Lowered her dose to 10 mg never complained again! Tylenol works well . No one can say there is no pain...

I also just found that the old remedy rubbing alcohol works great on my dads knees. He was in such pain ... Put a little on his knees and he felt great!

My dad has a pacemaker/defibrillator, pancreatic cancer, enlarged prostate and pulmonary fibrosis... He is in pain 24/7 , but refuses pain meds, until it is truly unbearable. They prescribed him butrol patch 5mcg... I am really worried about this patch,it is to be worn for a week at a time.... has anyone used these? or could help with my reservations about it? He is 83 with 20% of his heart and AFib....

Her pain could be parasympathetic pain dystrophy which is a hyper-sensitive reaction to the fracture. I had this when I fractured my left wrist, visited five doctors and finally got help from a pain specialist who diagnosed the problem. I had to tell myself every day the wrist was not going to be the same, and eventually it went away. No amount of pain meds will stop this pain until the mind tells the nerves to stop. Acupuncture will help, but she might be afraid of needles (which no one needs to fear as they do not hurt). Tell her to keep exercising and "wishing" the pain away. It worked for me, I hope it works for her too. Remember, the brain controls the body.

My dad has an extremely high pain threshold in his younger years. After he was in the nursing home and could no longer walk or care for himself he winced in pain when any of the nurses or CNAs tried to move him. I attributed it to his brain no longer sending or receiving the correct signals regarding experiencing a sensation versus actually being hurt. Still the pain was real to him at that moment and it was important for the nursing staff to treat it as such.

I was told that dementia can cause a person to feel pain that isn't there. Since it is an illness that is in the mind, I can understand that.

Maybe let her use her sling so it feels secure. Might at least change her focus if nothing else

I believe it does. My mother went wacko when she was given morphine for pain. The drug manifested itself into bad hallucinations.

Yes, I think it does. My mother too does the same thing. She literally runs with her walker sometimes ( I keep reminding her that 'Mama, its a walker not runner!) and other times, refuses to budge. We may think it is pretention, but I guess all that they need is attention and tender loving care. Keeping them busy works. When I am feeding her and she is busy she doesn't complain of any pain, the minute it is done, all the whining starts. can't help, just give a lot of TLC.

It is quite possible to have pain that is "not real." By that, I imagine the doctor means her pain has no physically identifiable cause. Remember that amputees frequently experience pain in the missing body part. Hypnotherapy can be quite effective with pain, even from physical causes. There is wide variability in the training and experience of hypnotherapists. I would look for one who is certified in another discipline as well, such as psychotherapy or counseling.

one of the first things they used to teach in nursing school is that if a patient says they're in pain then they are in pain. maybe the good doctor should take a few nursing courses

I think that when people get older the pain we feel is more amplified, then add to that the dementia and I am sure the brain even kicks it up another notch. Not saying that they are all like that. My dad would complain of pain in his hip, I said you are laying too much on one side or his knee would hurt. and as far as the therapy goes they should be giving her easy "warm up" exercises to slowly get the blood flowing before they start moving/stretching. and the massage is also good, easy at first. remember our skin gets thinner as we age. Also, with dementia once a thought is in their mind, it might be there for hours. My dad one day was talking about updating calendars from 1898.....I would try to change the subject, he would answer or say okay, but then go right back to the calendar thing. So maybe or maybe not she might be having pain. wishing you luck.

My mom (Who passed away 7 weeks ago) had stomach pain quite a bit. I took her to the ER, where they did a cat scan and could only find a left ovarian cyst, exactly where the pain was. Because of her age, or maybe because she was so frail, they didn't do anything. The doc said it would probably hurt more when it burst. Mom complained so much about the automatic blood pressure cuff that I hesitated to take her to the ER. Right before she died, she complained about the stomach pain again, although it seemed more severe. I waited until the next morning and she was clearly worse. We were getting her ready to take her to the hospital when she died in my arms. But the coroner thinks she a heart attack. She was supposed to be on oxygen but wouldn't wear it and her doc said that it would make her heart work harder if it didn't. I had to struggle some with my decision not to take her to the ER the night she started complaining of pain, but I had no idea, no one to tell me this pain was different. It had gotten to where she complained so much and I was rushing around so much, trying to appease her. Our hot water bottle was really getting a workout.....and me too!

My mom broke her back for the second time in May and then broke her hip in July. She broke her other hip 8/12 and has bilateral knee replacements with late stage dementia. Mom rubs her knees, hips or back and when you ask her does she have pain she says no. Her dementia/palliative care physician tells us to treat the pain bc she does have chronic pain related to her history of fractures and that her dementia doesn't allow her to understand that what she is feeling is pain.

Imop. Pain is a subjective experience. It is the patient's experience, nog the doctor's.
In agreement that massage or light touch can help alleviate pain.
Rub something in there where it hurts, your choice. That is whether the pain is real or just not real. You will be 'treating' what hurts either way. Use ice and heat.
In my own opinion.

Not vs. nog

dear debrakgray....this is going to sound terrible...but does anyone want to live with all that pain, all the time...getting older, broken bones, dam...enough is enough...she's in a better place NOW! Life...just living with no quality...to me...not worth it! lots of love...my mother is in the process of dying...but thank god NO pain...it's all I pray for...and a faster death.

There's a problem that develops with broken arms called frozen shoulder. In these cases the shoulder has contracted down and does not want to move away from the body. And boy, that's painful. Some younger people have MUA, manipulation under anesthesia involving being anesthetized and a big burley resident physician. So, yes following a fracture of the upper arm (if that's what it was) people can have a lot of pain. Narcotic pain meds don't have to be horrible, work with the doctor on that. Dementia can affect one's ability to communicate pain clearly, resulting in acting out. Watch how she behaves to determine the amount of pain she's in versus asking her to recall her recent degree of pain symptoms.

Empathizing...I have little tolerance for doctors who do not seem to understand what pain is. I get migraines. Normal migraine meds didn't work. I got accused of drug seeking all the time. It's downright nasty when a doc won't treat pain. Had a severe ankle sprain one time and the doc told me to take 800 mg of Ibuprofen - which did nothing. I think I'd switch doctors until you find one who will adequately treat your mother's pain. Would have to look it up, but there is a pain patient's bill of rights.

Liamalover - both of my parents would get completely stark raving nuts on morphine - one dose would be okay but as soon as they had a second - wow! Daddy never had dementia and only became delusional in his final few week but even then it was the text book delusions that hospice books talk about - thinking he needed to pack to go on a trip, thinking his deceased friends and relatives were visiting... But for years prior to that just a couple 5mg morphine would have him hallucinating and saying the weirdest things. I saw it happen a couple of times with my mom (she would swear there was a tall man in the room with us - soooo creepy!) but it was enough to decide on a different pain med. I asked a geriatric dr about it once and she said it was because the morphine built up quickly in the liver (or kidneys? cant recall which, for sure) and if the elderly person has any problems at all with this organ being impaired - it won't metabolize the morphine, just keeps storing and building up so its like taking a mega dose every time.

i broke my foot when i was 62 and i'm in really good shape. d*m...it hurt like h*ll after months of being in a cast! I was shocked when the physical therapist asked me to do certain things with that foot that seemed impossible with the pain!? I actually did my own therapy at home! Not sure how these elderly people hold up under this pressure!!??