Expert: Paula Damgaard - 1/30/2005

Question
I KNOW YOU DON'T HAVE ALL THE MEDICAL ANSWERS BUT HERE GOES.   DAD, AGE 90, IS IN THE LAST STAGES OF ALZHEIMERS. HE IS ALSO BLIND AND IN A CONVALESCENT HOME FOR TWO YEARS NOW.   MY QUESTIONS, I HAVE TWO, WHY DOES HE HOWL AND GRUNT, IS IT FOR ATTENTION, IS IT FRUSTRATION, IS IT ANGER, IS HE TRYING TO COMMUNICATE.  HE DOESN'T TALK AT ALL, WEARS DIAPER.  MY SECOND QUESTION IS AND TO ME PROBABLY THE MOST IMPORTANT.  WHAT IF HE IS IN PAIN, SAY A TOOTHACHE, A BAD PAIN SOMEWHERE.  HE CAN'T COMMUNICATE.  IS HE SUFFERING IN SILENCE.  BREAKS MY HEART TO SEE HIM LIKE THIS. I DON'T WANT TO SEE HIM SUFFERING OR IS HIS BRAIN TUNING OUT PAIN LIKE EVERYTHING ELSE.   THANK YOU FOR YOUR HELP.  I HAVE BEEN SEARCHING THE WEB FOR A WHILE NOW FOR ANSWERS TO MY QUESTIONS AND FINALLY FOUND YOU.  THANK YOU.

Answer
Dear Barbara,  I don't think anyone knows for sure if someone is in pain at the end or not. Nor do I really know if it is pain that is causing him to grunt or moan. My theory is if you think he might be why not treat it?  It isn't like he will become an addict or anything!  Just giving him Tylenol every six hours would be helpful to see if it helps the noise at all.  

If it does nothing, you have not done anything to harm him.  If it quiets him you might want to see if the doctor would try something a little stronger.  It can't hurt.  

If it doesn't help him you might ask the doctor to try a small dose of antipsychotic medication, like Seroquel or Risperidone to see if that helps him.  

I hope this helps. Let me know how it goes.  Paula