Re: How to deal with mother in significant pain

claudiav679124 · ‎10-21-2017

My 92-year-old mother lives a mile from me in a care facility; I visit most days. She is constantly complaining about pain of some kind. For the most part, between her doctors and the care facility, these pains have been addressed as best as possible. Her current stomach discomfort, I believe, is due to antibiotics she needs for a wound she sustained as a result of a fall. So that should subside in a few days. She also has chronic hip pain that an ortho specialist has said can't really be fixed at her age. So, we're left trying pain meds which upset her stomach (we add anti-nausea meds). But part of me also thinks she's attention seeking. But then, that seems unfair to speculate on. I want to help, it disturbs me to see her in pain, I feel that I accurately bring this up with caregivers....any advice/experiences on pain?

margaretf725870 · ‎10-26-2017

Hi Claudia,

This is such a difficult topic because pain is very subjective. I think the idea of exploring anxiety as potentially contributing to her feelings of pain is a good suggestion.

I am a Nurse Anesthetist, and my mother lived with us from age 94-99. I empathize with you about looking to past behavior to explain present complaints.

But, here’s a thought. Has the facility where she lives discussed palliative care with her/you? I would say hospice could be appropriate, but sometimes people interpret that to mean you are “giving up”. Palliative care is specifically designed for comfort. It is a part of Hospice care but not all Palliative care is Hospice care (what I mean to say is, all Hospice care has palliative care aspects, but not all palliative care is necessarily Hospice care).The reality is that at 92 all too often doctors are not willing to provide adequate pain relief. A palliative care specialist would be more comfortable with prioritizing your mother’s comfort over all else.

Is she able to quantify her pain using a 0-10scale? That can be helpful for the patient in order to understand oh, yesterday I felt it was a 7 but today seems to be a 3. Helps to keep perspective about it. The pain scale also helps RNs to understand what is working and what isn’t.

She might also benefit from a massage. If she cannot leave the facility easily maybe someone can come in once every week or so to give a very gentle massage. It can be expensive, but it is the sort of physical care that can be so comforting, especially because as people get to be of very advanced age, there is very little touching that isn’t related to hygiene. Even a gentle hand massage with a lovely lotion can be comforting.

I hope this helps. It can be such a helpless feeling when someone is in pain. I really hope that she can receive palliative care, and that your mind can be at ease.

best,

Margaret

claudiav679124 · ‎10-27-2017

Thank you for taking time to write such a timely reply, Margaret.

I've been taken by surprise at how dismissive care givers/doctors have been about her pain -- I thought pain treatment was a primary concern at this age; but you're right, it's not. I got her a little notebook for writing down things she wants to remember to tell me, and I'm making a part just for the 1-10 pain scale -- that will be easy enough for her to do (or for me to write down when I'm there) and I think that will be more of the data docs like:-(

I'd also been thinking about brining up palliative care and you've given me the words to use.

I appreciate everyone's responses so much.

JaneCares · ‎10-28-2017

@claudiav679124 wrote:
Thank you for taking time to write such a timely reply, Margaret.

I've been taken by surprise at how dismissive care givers/doctors have been about her pain -- I thought pain treatment was a primary concern at this age; but you're right, it's not. I got her a little notebook for writing down things she wants to remember to tell me, and I'm making a part just for the 1-10 pain scale -- that will be easy enough for her to do (or for me to write down when I'm there) and I think that will be more of the data docs like:-(

I'd also been thinking about brining up palliative care and you've given me the words to use.

I appreciate everyone's responses so much.

just catching up on caregiver posts here, where i learns so much, and i'm impressed with your questions and concerns, and with the awesome responses you've received! Hive mind to the rescue. Massage, palliative care, even hospice care if she's eligible and no longer wants curative therapy... very helpful stuff. Sounds like she's been Miss Crankypants for a long time, a kind of characterological negativeness. I was once a geriatric care manager and i was hired by a family who's mom was being evicted out of an assisted living place because she was SO cranky and even combative. So i tried to figure out what was the matter, and find another place where i could train the staff to do what she wanted. turns out she was very regal in her outlook and wanted to be respected and catered to, and among other things, NEVER BE TOUCHED. Oh and don't call her 'honey' or she'd bite your head off. I moved her into a new place, put signs on the walls and on her door, always knock and wait for a reply, do not barge in, never touch her unless you ask permission and she grants it, call her Mrs. ___. Woo boy, she was a tough one.

Whatever pleasure your mother can enjoy now would be helpful. Even a hand massage if she refuses to let anyone near her feet or the rest of her body. You could do that: it's like preparation for a manicure. Foods she likes, music she loves. Routine, people she knows, even if she forgets she knows them.

What a wonderful daughter you are.

How do you take care of yourself?

Jane

ManicProgressive · ‎10-21-2017

I'm so sorry you guys are going through this. 😞

Just a thought, because I've seen it in my family before. Is there any chance she has anxiety? Or is anxious about the pain or her health in general? Sometimes people really fixate on something like that and it makes it all worse. Has she said where on a pain scale of 1-10 the pain is?

And does the facility offer any type of pain management that isn't drugs? Physical therapist? Massage therapist? I don't know if they'd help, but I'd ask.

claudiav679124 · ‎10-21-2017

Thank you for your suggestions. Anxiety makes sense -- she does seem fixated. I should ask her about the pain scale. I think her facility has tons of options, but Mom is pretty negative. The wonderful director suggested a nurse with a psych background and my first thought was no...Mom would go nuts at any kind of "therapy" -- but then I said yes, if the nurse went in under her medical title and talked with Mom, that might be beneficial to see what she can draw out. Mom has been a difficult person all her life...very set in her ways and judgemental...and I have trouble not reaching to the past for explanations....when I know I should take her as she is and focus on the present. Thanks for this forum and your kind words.