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Alzheimer's Disease & Dementia Message Board

Alzheimer's Disease & Dementia Board Index

Danny, I understand your situation well having been through this twice, with Dad and then with Mom. The nurse is absolutely right about some with Alzheimer's not feeling pain. My Mom was one of them. She had sever arthritis in her hands. but in the final years of Alzheimer's she never once complained or acted like she was in pain as before. She broke her arm and never once winced. She showed no pain with the the UTIs that she had. She was only put on the comfort meds for breathing difficulties the last day of her life.

As for how to tell if he is in pain without him telling you, there are non verbal signs of pain that his nurses are trained to recognize. If he furrows his brow or scrunches up his face you would see that. If he clinches his fist and tenses his muscles that might be pain indication. If he is moaning or groaning it could be pain. Just think of the reflex actions we have when we have pain and you will know what to look for. He doesn't have to say he is in pain, you will see it in his actions and responses.

Mom made the very same request and there were time she would just bounce back. UTIs will respond to increased hydration or her body may fight off the infection on it's own. I have watched patients bounce back from worse. Yet something less can be what causes his last breath. If he is not eating, especially if it is a swallowing problem, then it is best to not force food. If he chokes easily, force feeding can lead to aspiration pneumonia from the food that is aspirated into the lungs. Aspiration Pneumonia would be difficult for him to overcome. With both Mom and Dad I offered and let them decide what they needed.

Hospice has a proven regime for the final stages. They have the medications that will help with pain, breathing, and the final stages. Just keep them informed of Dad's symptoms and they will do the rest. Their purpose is to keep Dad comfortable. Roxanol is usually the final medication they use. It is a super concentrated, immediate release, liquid Morphine sulfate that is taken orally and absorbed through the mucus membrane of the mouth. No swallowing is necessary. It not only control the pain effectively but also control the breathing as well.

So watch for the nonverbal signs of distress, let Hospice know if you see any, and depend on them to help you through.

My heart goes out to you and your Dad. My thoughts and prayers are with you both for comfort and peace :)

Love, deb

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