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Alzheimer`s Disease/Alzheimer's and Partial Hip replacement

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Hi Cindy,

My mother, who suffers from Alzheimer's, recently had partial hip replacement surgery (on Jan 30th).  She's been off pain meds for three days now.  I'm worried that she's in pain as she hasn't been herself.

A bit of context:  my mother is no longer able to speak (if she does it's generally gibberish with perhaps a few words that are sometimes in context and other times irrelevant).  She can't tell us if she is in pain or not.  We didn't even know she had a broken hip!  After the surgery, when she was on the pain meds, she was happy and actually spoke some complete, well placed sentences.  She also recognized people and called them by their name -- something she hasn't done in a long time.  Now, her eyes are glossy and almost teary-eyed, and she sleeps a lot.

Generally speaking, how long should she be on pain meds?  Is there a difference for patients suffering from AD?  

The staff at the hospital is willing to give her meds, but no one seems to know what to do, and they don't offer up any info.

Any ideas?

I appreciate anything you can tell me.

Answer
Hello Lisa:  I'm sorry to hear of your mother's need for surgery at this time of her life.  I'm sure it's hard on all of you to go through that with her.
Sometimes the pain centers in the brain seem to be affected in dementia and I too, have seen an elder with a broken hip walk on it and not display evidence of pain except a bit of a limp.  I've seen some serious injuries in these elders but they don't appear to feel the pain.  That being said, I would never assume they are not feeling pain.  If she cannot tell you about the pain, you would watch for facial grimacing, guarding of an area such as holding an injured arm still, or, as you're seeing with her, a change in her demeanor and sleeping more.  If she grimaces, moans or gasps when moved, then she is having pain.  The same if you palpate the injured area and you get any of those responses.  If this were my mother, having just gone through major surgery, and I saw these changes in her demeanor, I would ask that she be put on something round-the-clock just to see if it helps.  Even if it's something as simple as Tylenol (which can be very effective for these elders), it won't hurt to try it, and wouldn't it be wonderful if she perked up.  There is no way to tell how long she might need pain meds because everyone is different, but keeping her on them for at least a week or so and then trying to wean her off them to see if there are changes would be a good way to proceed. Who knows, she may require them for months if something isn't just right with the surgery.  I wish you luck Lisa as you advocate for your mother during these trying times.  Cindy  

Alzheimer`s Disease

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Cindy Keith, RN, BS, Certified Dementia Practitioner

Expertise

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.

Experience

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.

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

Publications
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"

Education/Credentials
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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