Thursday, September 11, 2008

Signs of Pain

There are many signs of pain. Bizarre behaviour proved to be one of the. One day Dad wandered down the hall, still in his wheelchair. He could not walk on his own and had lost the ability to move around independently. He ended up pulling the fire alarm. I was mortified! At least I knew they cannot kick him out of this Long-Term Care home. In the retirement home I was always worried.

I worry about having to restrain him. He is terribly confused and groaning a lot. We did not know if he is in pain or what we could do about it. The staff gave him some Tylenol to ease his pain. It might simply have been his knees that agonized him, but, again, we did not know. He could not communicate this to us.

Pain is not a normal part of aging. It is fairly common in Long-Term Care Homes, and ought to be addressed. Chronic pain is pain that persists for 3 to 6 months after it is expected to, after healing from something. Persistent pain is pain that lasts longer than a month. Dad has always had persistent pain, due to the arthritis in his knees, and this has never been adequately addressed. All of us tried many things but did not find relief – or he give up. He bought the magnetic wraps that are supposed to help, but gave those up. In the summer we put some topical ointments on his knees. After the radiation treatments on his forehead he put some of this, accidentally, on his forehead when he isn’t thinking straight. In the past Dad indicated pain, but he is beyond that now. A great resource regarding pain is at BP Blogger's monthly newsletters. This one, on pain (click here: for PDF) is excellent. They have many others covering a variety of issues.

There are non-specific signs of pain: frowning, grimacing, grinding of teeth, fidgeting, bracing, rubbing, striking out, increasing or recurring agitation, poor eating or sleeping habits, sighing, moaning, groaning, decreasing activity levels, resisting particular movement, change in gait or behaviour or loss of function. Dad had all of these and, in hindsight, was clearly undermedicated.

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