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Pain Management: Dealing with the Psychological Effects

It’s a subject of considerable debate in the medical world: what is the pain threshold and pain perception for patients suffering from dementia or Alzheimer’s disease? One school of thought holds that these patients have a higher pain threshold and lower pain perception; another holds that these individuals sense pain no differently than anyone else, but merely lack the means to articulate what they feel. Anecdotal evidence falls on both sides of this debate. The science, it turns out, is more conclusive. Princeton Health Care Center explores the psychological effects of pain.

Psychological Effects of Prolonged Pain

Absent pain management, long-term pain has a number of physiological effects, including a suppressed immune response, muscle and tissue damage, hypertension, and increased risk of cardiopulmonary events. However, the effects aren’t merely physical; there are psychological side effects of prolonged pain as well.

Among the psychological effects:

  • Anxiety or paranoia
  • A higher incidence of depression
  • Confusion and disorientation
  • Insomnia and disruption of sleep patterns
  • Inability to concentrate
  • Interference daily activities
  • Cushing’s Syndrome/hypercortisolism, a disorder caused by excess stress hormones

Detecting Pain

Of course, tying any or all of these symptoms back to pain is difficult when someone suffers dementia or Alzheimer’s disease. After all, many of these symptoms will already be familiar to caregivers! How, then, can you tell if what you’re seeing is a result of poor pain management versus the normal progression of the disease?

Sometimes — especially in the early stages — there may be verbal cues, especially if you ask whether someone is suffering pain. At other times, however, you’ll have to observe more carefully. Look for nonverbal cues like a pained facial expression, a change in someone’s gait, or a sudden change in disposition. Understand, however, that if someone was accustomed to putting on a brave face before, they’re likely to do the same now, even without realizing it. Old habits die hard, after all.

What Can You Do?

We’re used to being not only caregivers, but also fierce advocates, for those we love. If you sense something is wrong, insist that your primary care physician or specialist digs deeper. This is especially true with general practitioners, who may not have the training or experience to deal with these issues. Even specialists — whose list of patients is often longer than the time available on any given day — may seem rushed. Bottom line: that’s not your problem.

Adequate pain management isn’t just about pain, after all. As we’ve seen, there’s a host of physical and psychological issues that also come into play. And if that’s not enough, this is someone you love, and it’s their quality of life on the line. You’re well within your rights to speak up. That’s especially true since pain generally accompanies something else, and that “something else” could be anything from a sprained ankle to a severe infection.

For care with a personalized touch — including not only pain management but also a range of activities designed to give meaning and purpose to older individuals’ lives — contact Princeton Health Care Center today.

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