Bursack: Dig deep to find source of pain for mother with dementia

Carol Bradley Bursack, Minding Our Elders columnist. Special to The Forum
Carol Bradley Bursack, Minding Our Elders columnist. Special to The Forum

Dear Carol: My mom was recently diagnosed with vascular dementia and Alzheimer’s. She’s become increasingly confused when she tries to explain something, so we don’t know what to think about this. She had a root canal two years ago and did fine, but now she’s having pain that she says is coming from that location. The dentist who did the surgery took X-rays and sees no reason for the pain. A second dentist agreed, but my mother continues to hurt. Two weeks ago, we took her to the emergency room. They found nothing wrong but gave her some minor pain medication and we brought her back to the nursing home. The staff there is very concerned. So am I, of course. So far, though, no one can pinpoint the cause. Do we ask for stronger pain medications? We are at a loss about what to do — KL.

Dear KL: My sympathies to you all. No one wants to see a vulnerable person like your mom in pain, and when you’re trying your best to determine the cause without success, it’s frightening to see no answers emerge. Don’t give up looking for the cause, though.

Pain medications may work short-term, but overmedicating someone like your mom is rarely a good solution. Here’s one thought based on a friend’s experience with oral pain. After nearly a year trying to discover the reason behind symptoms in the area of an old root canal, her dentist finally suggested that there could be damage that didn’t show on X-rays. Apparently, he was correct because extracting the tooth solved the problem.

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My second thought takes me back my dad’s experience. He’d developed dementia and couldn’t always articulate clearly when reporting pain, yet there was no doubt that he was suffering. The doctor couldn’t determine the cause of Dad’s pain. The staff at the nursing home had also tried everything.

Then the physician’s assistant who saw Dad regularly went through his medications. They’d prescribed the drug Neurontin for some reason unrelated to pain, but the side effects of this medication can actually cause the type of pain he seemed to be experiencing. With nowhere else to go, the PA took Dad off of Neurontin, and he started to improve. Within a few days, Dad was back to normal.

My point is that any drug can backfire. For this reason, I’m suggesting that your mother’s medications be examined for the potential to cause pain anywhere in the body. Additionally, while she indicates that her jaw hurts, that doesn’t necessarily mean the pain is in her jaw; something wrong in her neck or throat could cause pain farther up.

Finally, everyone helping your mom knows this, but a reminder can’t hurt. People living with dementia might not use the correct words to describe the perceived location of the pain, so watch her body language. Challenging as it is, keep pursuing a solution to this puzzle.

Your mom deserves to live out her life with as much comfort as possible.

Carol Bradley Bursack is a veteran caregiver and an established columnist. She is also a blogger, and the author of “Minding Our Elders: Caregivers Share Their Personal Stories.” Bradley Bursack hosts a website supporting caregivers and elders at www.mindingourelders.com. She can be reached at carolbradleybursack@mindingourelders.com.