In order to understand what kind of a pain dementia brings, we must first know what dementia is. Dementia is a disorder of the mind, affecting perception, memory and judgment. It is described as the condition in which the ability to remember is reduced, as well as the control of muscular movements and possibility to recognize familiar objects and sounds. People who suffer from dementia often have a high risk of under-recognition and under-treatment of pain, and this may happen when they normalize pain. The level of pain is individual, and we all experience it differently, but since demented people slowly lose their ability to speak, they can’t tell us if something hurts them and due to the loss of memory, they simply can’t remember if they were in pain. They also often forget why they are drinking pain-killers and there must be someone to remind them of it.
It is important to detect the pain in people with dementia. It could be difficult but medical staff should learn and pay attention. They can spot if there is a change in their behavior, if they are afraid of going on a physical care, or if they repeat certain actions, if they wander, or if they are agitated by some things by which they were not before. Some changes in the mood may also be noticed, and, as we have said earlier, depression and refusal to socialize are noticed. Signs of the body, speech and signs on the physical examination can contribute in understanding if demented person is suffering.
How to treat people with dementia? Firstly, a complete assessment must be done. Then, you should always be patient enough, in order to understand what demented person wants to say. If they can take care of themselves and help them, make sure that their teeth are clean, get them comfortable shoes and cloth. If simple painkillers do not help, give those stronger ones like codeine and morphine, since they are used for more serious pain. Medical tests which involve stabbing of the needle or some invasive physical investigation shouldn’t be done so often. And, if medical staff realizes that the death is near, they should do everything in their power to keep the patient comfortable and free of pain.
Although this was not a practice in the past, we as a community must accept those people with due respect and treat them in a proper way, because they are one of us.