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I find it odd that my mother in law always complained about her knee and every time she had to stand up or walk she would carry on about the pain. Now that she has dementia it never comes up. Just curious if you lose the pain or she was faking it.

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The brain is a big part of the perception of pain. That's one reason we have to watch for body language that may indicate pain that they can't articulate. We don't want to make the mistake of thinking that they have no pain just because they don't say that they do.

Arthritis pain can come and go and even certain movements or sitting in certain ways can make it better or worse (in some cases). I'd watch for limping or other signs of knee pain but for now she is either not perceiving the pain or she is having a bit of a remission. Just stay alert.

Great answers from the community as always!
Carol
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Did it seem to you that she was faking it before? Did she have a diagnosis? Did she take meds for it?

Dementia indicates there is a problem in the brain, and depending on the locations of the problems many different symptoms and reactions can be experienced. The perception of pain can change.

I just read about a woman with dementia who fell and her family took her to the hospital as a precaution. X-rays showed a broken collar bone. The hospital staff was amazed she felt no pain.

On the other hand, dementia patients may perceive pain when there is no detectable cause for it.

Other things that can be effected by having dementia include the sense of smell, depth perception, the sensation of being hot or cold, and the sense of taste.

Dementia is very definitely not limited to memory issues. In some kinds of dementia memory is a secondary problem.

If strange behaviors or odd reactions happen in people with dementia, the dementia itself should be among the usual suspects. If she has no pain where she used to, or suddenly can't stand the smell of flowers she used to love, or puts hot sauce on her food when she used to hate it, or is very annoyed at a sound that didn't used to bother her -- just keep in mind that her brain controls all those reactions, and her brain is now damaged.

So whether or not MIL was faking the pain before, be glad she is free from it now. Dementia rarely has a silver lining -- accept this one gratefully.
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my wife had arthritis - no faking that - with swollen joints and lots of pain....now she has alzheimers she no longer seems to have pain from it at all.. no longer takes the numerous pain relief medication she did before... that is the only silver lining i have found so far!
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You can't really assume she was faking it. Dementia often renders a person unable to communicate pain accurately. My Mother had arthritis pain most of her adult life but as she got older she was unable to give a severity number to her doctors to describe the pain. One hospice nurse suggested putting her on a Fentintyl patch for pain because she would say she was not in pain but she could not sit still, would pull at her hair, bahave angrily, all things the Doctors told us were anxiety, but the Nurse believed it was pain. Now that she is on the patch she is much calmer, pleasant and describes no pain.As always have the conversation with as many health proffesionals you need to, in order to gaet the answers you need.
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I wish to add that no one knows another's pain, till you walk in their shoes.
Sometimes the pain is worse but I would never assume that anyone "fakes" it.
That would be a judgment....one I do not make.
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I have been caring for a husband with dementia for over 12 years, and his pain level has certainly not gone down as the dementia progressed. He has severe arthritis, spinal issues, and extensive nerve damage from a deteriorating spinal fusion. All this was documented by doctors, both before and after diagnosis.

One of the fears I have about him being in a nursing home is that they will not take his pain seriously. (I have read that some "problem behaviors" in nursing homes got much better when patients were given medications for pain. That only makes sense. It's a very rare elderly person who doesn't have some issue that would cause pain. Certainly, if all of my own pain meds were taken away from me, there would be some serious behavior issues!)

One thing I have noticed about his pain is that he is not nearly as stoic about now it as he was back before dementia came along. He just doesn't have the mental resources to deal with the constant pain now. The pain is continuing to get worse as his physical problems worsen, but his coping skills are deteriorating. It's very sad to see him suffering with the pain.

By the way--one problem many elderly people have is a vitamin D deficiency. A low level of vitamin D can cause quite severe pain, in both bones and soft tissue. At the last nursing home where my husband went for respite, nearly every patient was on a vitamin D supplement.
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I did an interview with my mom yesterday. Before her mind goes i wanted her to tell me what its like to be old. She related some very interesting things to me and told me i had her premission to share her thoughts, which i will later today. But one thing she told me about her pain is that she does not let on to others how much pain being old carries. For two reasons, one if she can bare it she doesn't want to worry others and two she tries to block it out not dwell on it. When she needs a pain pill she asks but there are times, really all the time i can see she hurts and that hurts me too. Pain is a very real monster we all deal with, just think of the last time you had a tooth ache...now there is real pain! My alz client does not communicate much any more but as others mentioned i look for the clues, limping, rubbing or pointing at her knee they are there if you watch for them. I do hope the best for you and all who deal with pain issues. I would never minimize it to anyone. Ruth Anne
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There are three kinds of pain...physical, emotional and spiritual . One might stay their pain in similar literal terms yet origin is quite different and may continue unaddressed. It's possible that this person was experiencing spiritual pain which is less amenable to medication.
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Not necessarily faking it for attention before. My aunt used to be able to articulate pain well, and went to the correct doctor/dentist to take care of it. Now she doesn't say so, but behavior tells us. For example, she suddenly stopped chewing food. She didn't know why when asked, or couldn't find the words. I took her to a dentist, who found a broken tooth, and cavities needing tooth removal. She got new dentures as well, and is again chewing dinners.
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It has been my experience that the more my Aunt's dementia increases, the more difficult it is to describe or even acknowledge pain. I know she hasn't been faking lately (though I think early on she exaggerated to get attention). So rather than assuming she was faking, err on the side of caution and assume she doesn't recognize the pain and, as has been stated, watch her body language and act accordingly. Good Luck!
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