Alzheimer`s Disease/Dementia patient pain


My mom, 86 yrs. old had Alzheimers dementia that was very controlled by her medications. In fact she could still tie her shoes and we'd go to the Senior Center for lunches.

In May, she had an excruciating headache and asked for 911 to be called. Her BP was over 200. She told the EMS that her head "hurt bad". (She'd been literally howling over the pain in her head.) On the way to the hospital she told them she needed to go to the bathroom  & that she was going to vomit. (She did neither)

In the ER, Chief Complaint: Headache. They didn't scan her head, tho.

She said she needed to use the bathroom, so I had someone get her a bedpan. She passed a lot of urine and had a good bowel movement.

In the process of using a short cath for a urine sample...she cried out in pain and asked: "What are you doing!?" I told her they needed a urine sample. Then, they inserted a foley that was absolutely excruciatingly painful. She kept screaming: "OW!" My sister and I had never heard anyone scream like that, before.

The RN pulled the foley out and I asked her if it was really necessary, as Mom had just passed a LOT of urine in the bedpan. She 1/2 laughed and said: "We don't make very many friends when we do things like this." and literally rammed that foley into Mom. OH, poor MOM! She was screaming and screaming "OW! OW! OW!" and got deathly quiet in a coma like state. The RN never said a word and walked out.

I thought Mom was dead right then and there. She was put into ICU for 3 days and literally deteriorated and they discharged her. She never regained full consciousness. She died 22 days home.

I've been talking with the hospital staff and hust this week talked to the 2nd in command of the entire hospital system & she told me that Mom had a stricture in her urethra and when the straight cath broke thru it it was painful, but..because Mom had dementia, that's why she screamed so badly.

Does that even make sense to you? Just because my mom had dementia is the reason she screamed so badly as they broke through the stricture in her urethra?

She was screaming so badly, I thought sure her heart would explode. Looking back, I can't help but believe she had a brain bleed.

I will really appreciate you answering the pain question...because it doesn't make sense to me. Even a "normal" person would be screaming out due to the pain of breaking through a stricture.

btw...The hospital staff has told me the "matter is closed" and they won't talk to me anymore.

Hello Jean:  I am so sorry to hear about your mother's terrible experiences at the hospital, as well as your having to witness it all with her.  
In my opinion, having dementia means that various areas of the brain are being destroyed or damaged by the dementia.  I have seen elders with dementia walk on a fractured hip and not appear to experience pain, and another person that when they fell and received a 7 inch gash on their arm said it didn't hurt.  Opposite of that, I've seen elders with dementia cry out in obvious pain at the most gentle touch.  There is really no way to tell if they were actually experiencing pain, or if they thought they were.  Either way, during the catheterization, the nurse should have stopped when your mother was having so much pain.  They probably wanted a "sterile" urine specimen and could not use the one from the bedpan since it also contained feces and would contaminate the sample, so that is why they were trying to catheterize her.  I would tend to agree with you about the brain bleed being the cause of the head pain, and if the family reported to the ER about the excruciating pain she had, they should have done some type of scan of her head.  It's been a long time since I did any bedside nursing, but it seems to me that they could have tried a much smaller catheter, or had her drink lots of fluids and try to urinate a bit later rather than putting her through so much pain.  How can they be sure they didn't rupture her somewhere during that catheterization?  What we were taught in nursing school is that when the patient says they have pain, then they do have pain, and while sometimes it's necessary to cause pain, I'm not sure in that instance it was all that necessary.  It's so unfortunate that you and your mother had to experience this and I hope you are able to find some peace over it soon.  Cindy  

Alzheimer`s Disease

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Cindy Keith, RN, BS, Certified Dementia Practitioner


As a nurse and dementia consultant, I can answer most questions on all types of dementia. If I cannot answer your question, I will attempt to find someone who can. My passion is to help caregivers of people with dementia, which in turn helps all those wonderful elders with dementia live better lives. When caregivers are better educated, they are able to better care for themselves and their loved ones, so education is key to decreased stress levels and healthier, happier families.


I have worked as a nurse in various disciplines of nursing for over 20 years, most of which was with the elderly. I was a health care coordinator in a dementia dedicated assisted living facility for 4 years before I started my own business (M.I.N.D. in Memory Care) as a dementia consultant six years ago. As a dementia consultant, I help families nationwide through phone conference calls as they struggle to care for their loved ones with dementia.

Alzheimer's Foundation of America Geriatric Interest Network Sigma Theta Tau International

Published "Love, Laughter, & Mayhem - Caregiver Survival Manual For Living With A Person With Dementia" which is a collection of stories about people with dementia I have known, loved and worked with. Every story has a lesson to teach and this book gently teaches family caregivers lessons about how to better care for their loved one, as well as themselves during their caregiving journey. Published "Love, Laughter, & Mayhem In Eldercare Facilities: The Master Key For Dementia Training" Created "Bringing Nurturing To Memory Care" staff dementia training video Created Ebook: "Hair Stylist's Helpful Tips For Working With People With Alzheimer's & Other Dementias"

Registered Nurse with Bachelor's degree in Nursing; Certified Dementia Practitioner; Author of 2 books and an ebook

Awards and Honors
Sigma Theta Tau National Honor Society of Nursing

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