How can I know if pain is real or obsession?

Nett b asked...

My mother is in mid-stage Alzheimer. She constantly complains about one thing or the other hurting (head, arm, hip, back and legs). I personally think that she is obsessing rather than in real pain. If you get her mind off of it then she seem to be OK. I don't want her to be in any real pain, nor do I want her to be doped up on pain meds. What do you think?

Expert Answer

Monica is an occupational therapist and designer of adapted dementia products through her company MindStart. Activities for Persons With Memory Loss. In addition, she works with the Minnesota-North Dakota Alzheimer's Association and the University of Minnesota on dementia issues. MindStart provides age-appropriate and stage-appropriate dementia activities, such as games, puzzles, and books. The items are simplified to meet the needs of various stages of dementia while remaining dignified and familiar in appearance

This is a difficult situation, as people in mid-stage Alzheimer's do have difficulty communicating their wants and needs. I would suggest you track for awhile when your mom is complaining of pain; where the pain is on her body; and other things that are happening at the time (or not happening). With this information you can first talk to the physician to address any true pain she may be having. For instance, if she consistently reports pain getting in and out of bed and in and out of a chair, perhaps she is having arthritic pain in her hips, knees, and/or back. The second thing you can do with the information is evaluate what else was happening at the time she complained of pain. She may be actually be feeling something different than pain, but does not know any other way to express it. For instance, she may be bored, frustrated, scared, hungry, hot or cold, overstimulated by too much noise, etc. If so, try to address this and see if the complaints of pain go away. For example, if you think she might be bored, try engaging her in a task or activity and see if that helps. Another suggestion would be to have the physician order physical therapy, as they can help to evaluate pain and treat it without the use of medications. Take care!