By:
Kim Butrum, MS, RN, GNP
Senior Vice President, Clinical Services
Next month (April), Loren Shook, Wayne Sanner and I will be attending the Alzheimer’s Disease International meeting in Lyon, France. We have been asked to share Silverado’s ongoing experience as the only US entity to have achieved ADI accreditation of our Education and Training program.
Silverado has also been selected to present a poster at ADI on our experience over the past 10 years of presuming physical discomfort and treating it BEFORE using psychiatric medications for behavioral expressions such as agitation. Every national and international guideline around behavioral expressions in dementia for the past 20 years has recommended considering pain or discomfort treatment before other treatments, particularly psychiatric medications, are used. However, that has not been our experience when working with other healthcare settings and professionals.
Many health care professionals and others in the US assume that a person living with dementia can aways correctly identify and communicate that they are experiencing pain or discomfort. We have many examples of people living with dementia who deny being in pain, yet when pain medication is given on a regular basis, the behavioral expressions resolve and allow the person to engage in normal activities.
We have observed many cases where, after a clinical assessment and with the use of an objective pain scale like the PAIN-AD, presuming discomfort and giving routine analgesia has extinguished a behavioral expression. Sharing these success stories can be a powerful teaching tool and may help break through biases, prejudices and assumptions that all symptoms a person living with dementia presents are due to their dementia.
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