Remember This - 2012: Second Seminar

Remember This - 2012: Second Seminar

Pain Management and Dementia


“Remember This” Seminar Series

This 2012 series of lectures, designed to address crucial topics in dementia and memory care, is presented in conjunction with the opening of Cohen-Rosen House, a new memory care residence. The seminars are sponsored by the Hurwitz Lecture Fund at Charles E. Smith Life Communities. Here are notes from the second lecture:


 “Assessing and Managing Pain in Patients with Dementia”

Presenter:  Allan A. Anderson, M.D.

From a toothache to arthritis, from a fall to surgery, pain affects most of us, including individuals with memory loss. In fact, pain is often age-related, so if you are over 50, chances are you experience some pain. 

Because many persons with dementia lose the ability to verbally describe discomfort and pain, caregivers should be attentive to signs indicating that pain may be present, such as:

  • change in gait
  • fidgeting
  • grinding teeth
  • increased aggression or agitation
  • moaning, groaning, crying, yelling
  • resisting certain movements during care
  • poor appetite or sleep

There are several scales that caregivers can use to identify and track pain, from asking a patient to point to happy or sad faces to more sophisticated assessment tools which ask caregivers to observe facial expression, body language, movement, mood, appetite, physiological changes and more. 

The trick is to focus treatment on relieving the pain rather than on controlling the undesirable behaviors. Possible approaches include:

  • massage therapy
  • acupuncture
  • chiropractic treatments
  • more frequent toileting, exercise or repositioning
  • checking clothing and dentures for comfortable fit
  • moist heat
  • pain medication, from over-the-counter to topical agents to opiods

“If pain medication works, give it routinely,” Dr. Anderson advises.  “Pain and discomfort should be treated in collaboration with all of the health care team, and family members can be important observers and advocates. Tylenol is not the drug of choice for all pain,” he notes. 

Once relief from pain is achieved, other goals can focus on improved ability to perform activities of daily living, improved mood, cognition, behavior, sleep and daytime energy, and greater participation in activities and in attaining therapeutic goals.

[Dr. Allan Anderson is widely published and lectures nationally. He is Medical Director for the Alzheimer's program at William Hill Gardens Assisted Living at William Hill Manor, and Geriatric Consultant for William Hill Nursing Home and William Manor Retirement Community. In 2011, Dr. Anderson became president of the American Association foro Geriatric Psychiatry. At the Samuel and Alexia Bratton Memory Clinic, Dr. Anderson leads clinical trials of novel medications for Alzheimer's disease.]


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