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It’s a dreadful thought, but one that it’s wise to consider if you care for someone who has dementia.  For whilst knowledge and awareness of the condition is growing rapidly, our understanding of pain in dementia care still has a long way to go.

And it isn’t only family and friends who are struggling. A study published last week, jointly funded by Alzheimer’s Society and Bupa Foundation, investigated the link between pain and delirium in people with dementia and found that many dementia patients in hospital are experiencing pain which goes undetected, often because they’re simply unable to verbalise how they feel.

People with dementia are at high risk of developing delirium, which can dramatically increase their level of confusion and, if left untreated, make them very unwell. The study seems to suggest that pain may be a key cause of delirium. Researchers conclude therefore that if hospital staff can identify patients who are delirious, this could be a good indication that they are also in pain…

But delirium can be difficult to spot and is often undertreated in hospitals. ‘The link this research reveals between delirium and pain shows that the problem may be worse than previously realised,’ says Dr Doug Brown from Alzheimer’s Society. ‘We now need to take steps to ensure all healthcare professionals have the right training to identify such distress in order to properly care for people with dementia.’

However, it’s probably easier for you to spot signs of delirium in the person you love than it is for hospital staff.  Why? Because you’re the person who knows them best and – crucially – you know what level of confusion is ‘normal’ for them… and what isn’t.

5 facts about delirium
Anyone can get delirium, but dementia significantly increases the likelihood
* Delirium is often caused by an infection (commonly urine or chest) but can also be caused by pain, constipation, medication, dehydration and changes in routine/environment
* There are two types of delirium; hyperactive delirium and hypoactive delirium
Symptoms of hyperactive delirium include heightened emotions, hallucinations, paranoia, restlessness, and being unable to sleep
* Symptoms of hypoactive delirium can be harder to spot, they include lethargy, withdrawal, depression, sleepiness, and inability to focus or concentrate.

Can it be treated?
Yes. Once the underlying cause of the delirium has been found it can be treated and the delirium usually improves within days or weeks. For example, if the underlying cause is found to be a UTI, after a course of antibiotics the person you love should rapidly improve.

2 more ways to help prevent pain:

1- Learn how to spot it

Sadly, communication does become increasingly difficult as the dementia journey progresses. Even if you know the person extremely well you might still struggle to work out what’s wrong. Try looking for nonverbal signs of pain, such as body language and facial expressions. We’ve complied a special guide and set of Visual Pain Assessment Cards to help you with this. Go here to find out more https://dementia.livebetterwith.com/collections/treatment-planning

2 – Increase your knowledge

Forewarned is forearmed, so the more you understand about delirium and the other common conditions you might face on the dementia journey, the better. These free eBooks, Staying out of hospital when you have dementia and Going into hospital when you have dementia, were written by dementia specialist Danielle Wilde. They’ll provide you with all the information you need to prevent and treat ill-health at home and to cope with a hospital admission.