Alzheimer disease and pain control
Alzheimer’s disease is a form of a degenerative brain disease that results in progressive disorientation, memory loss and confusion. This is also sometimes called senile dementia because it usually happens later in life.
Several risk factors for the disease has been identified, one of which is high cholesterol levels. There may also be a genetic component since people in families with Alzheimers have a higher risk of developing the disease themselves.
The literature on pain management for people who suffer from Alzheimer’s is slowly gaining ground. There continues to be a need for more research into the treatment of pain to improve the comfort of these patients as well as the quality of their life.
Because the majority of those who are suffering from Alzheimers disease are elderly some of the same criteria for treatment are used as those for the geriatric patient. Providing effective control in the elderly is a challenge to health care professionals for a variety of reasons.
The elderly patient who suffers from Alzheimer’s may also suffer from a physical condition that causes a significant amount of discomfort, such as arthritis or joint disease. Pain is a common concern among older Americans it affects more than 33 million who are older than 65 years. Other studies have shown that 62% of people living in nursing homes have pain and that the range of those living in the community who suffer with pain ranges between 25% and 50%. The difference in these numbers proves that pain is under treated and under diagnosed in the elderly.
The American Medical Directors Association has defined pain as an individuals unpleasant sensory or emotional experience that is recurrent or persistent. There are different types of pain as well. A person will perceive the pain of a toothache, muscle strain or deep incision from surgery as totally different. An medications or more natural approaches should address the type of pain as well as the source.
Care givers have found that there are barriers to pain management in the elderly population that include but are not limited to: Some believe that pain is an inevitable part of aging that is unavoidable, that pain indicate that death is near, that pain is a punishment for past sins, or that pain could be an indication of a serious illness. These beliefs of the older adult population is complicated by the belief that complaints of pain could result in expensive tests or the loss of independence.
There are several approaches to pain management in the elderly that include medication or a more natural approach. Pain medications or other approaches should always address the source of the pain and not try to blanket the pain, unless the pain is caused by a terminal illness that cant be adequately addressed.
Medications that are popular are Acetaminophen, Non-Steroidal Anti-Inflammatory medications, COX-2 inhibitors, and opiods. Each of these classes of medications have their pros and cons carrying side effects and drug interactions with other medications the individual may be taking.
There is also a benefit to trying alternative methods of pain relief if you are certain that you can ascertain if the patient has reached adequate pain relief. When a person with Alzheimer’s disease has reached the latter stages of their disease they are often unable to communicate verbally. If there is a caregiver who is able to read this individuals body language appropriately more holistic approaches may be attempted.
Most people find relief from their pain in joints when the problem is addressed through physical therapy. This particular method is next to impossible with those in the latter stages of their disease. Acupuncture is another option that works well for those who dont have a great deal of range of motion or may be unable to participate in the healing process.
Exercise, stress management, diet and dietary supplements (to correct nutritional imbalances that can increase the perception of pain) and Bioelectric therapy round out the options for the elderly population but arent as effective in patients who are unable to participate in their care.
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