![]() Here’s a great resource for people who are dealing with a family member or patient with advanced dementia–Palliative Care Dementia Resources. It separates the resources by topics and is easy to follow. To me, some of the most disturbing symptoms of dementia are emotional and mental pain. It can be devastating for everyone, but not as much as for the person who is sitting with that kind of discomfort. Medical professionals are getting better with the physical manifestations but when it comes to emotional anguish, we don’t do so well. The reasons for unsuccessful treatment are varied. People who are close to the person, either personally or professionally, are very passionate in their views about how to handle it. It makes it hard to have an open mind.
Have you ever walked through a nursing home and hear the same person screaming over and over again? Do you say to yourself, “oh there’s Mr. So-and-So, he’s at it again,” or “I wish she’d stop yelling like that, why they won’t do something?” Or, are you so used to it that you walk right on by undisturbed? The person is experiencing emotional pain, plain and simple. If the person can be soothed by your presence or the presence of another and you can be with them most of the time, then you are very lucky. But what if you can’t be there? What if your parent at the nursing home is one of the people who is constantly angry or yelling or ‘causing trouble?’ What if you don’t have the money to hire a sitter to be with them most of the day? Please know there is not one nursing home that has the staff to sit with your loved one much. Maybe, maybe 10 minutes tops, here and there. They cannot do it and they don’t. They are too busy with all the other residents. So what’s left? Hope they get better? Tell ourselves that what they are afraid of isn’t real so it’s OK? Tell ourselves that she was always bitter/angry/dramatic/an attention seeker and this is nothing new so it’s alright? Even if that is true, it doesn’t change the fact that she is in emotional/mental pain. What are we supposed to do? To hope that it will stop is usually where most of us begin. What is the only solution if the emotional/mental pain doesn’t go away? The answer is some form of treatment or substance introduced orally or topically or energetically. We start with whatever we believe in and go from there. If we’re open to non-western types of healing, then we can try acupuncture, aromatherapy, reikki, essential oils and any of the other modalities. If they don’t work, and there is nothing left to try from the array of non-psychotropic medications for dementia, then we can try using medications from the anti-psychotic and/or anti-anxiety class. “No, it’s too dangerous,” we say. It will prematurely kill them. It may kill them just like any other drug can, it is true. No drug should be used without careful consideration. There are always risks to every medication and always trade offs. Emotional pain doesn’t dangle like a broken arm and it requires treatment just like the broken arm does. They have a broken heart and a broken mind. Imagine the last time you were hurt, angry, really offended or really sad. Sit in that for a minute. Now imagine you have no rational defense against it. You have no reasoning power to talk yourself out of it or to change your focus and think about something else. Its not that you are not a positive thinker, it is that your brain has deteriorated and the electrical impulses are not firing the same. There is deteriorating physiological changes in the organ of your brain (see picture above). With both medical professionals and families alike, there are many who believe we are ’sedating’ a person when we give them medication for emotional/mental distress. Know that if a person is sedated, then they are getting too much of the drug or they are getting the wrong drug. If our belief is to give medication for physiological disease processes, and we accept that their dementia is a physiological disease process (see picture), why is our reluctance to treat them medicinally so emotionally loaded for us? When I walk by an elder with advanced dementia that I know is consistently distressed, I think about if that were me. In that condition, I would be powerless against my thoughts and feelings with no defense against them. My hope is someone would advocate for me and begin the process of finding a medication that worked. I hope they would continue to change doses and medications until I was pleasantly enjoying my day, even if I had to take an extra nap or two. Naps are great. What would you want?
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AuthorIn fall 2014, I moved some old blog posts here that I had written years ago from 2007 to 2010. Hope they are helpful. Archives
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