McKnight’s Articles

Residents with cognitive impairment don’t feel pain

Rose was 86 years old when she required surgery. The procedure itself was straightforward, but Rose had Alzheimer’s disease. The hospital was right to send her to our skilled nursing facility hours after surgery, knowing we were best equipped to care for her, given her significant cognitive impairment.

The doctor at the SNF denied the possibility of Rose being in pain, stating “Alzheimer’s disease acts like a buffer to pain”; he instead attributed the change in her behavior to her dementia.

“Rose’s rocking back and forth and moaning was a manifestation of her brain disease,” he shared.

Wait, what? Scientific evidence does NOT support the idea that people with dementia do not feel pain. They may express pain differently, but they DO feel it. This blog’s title and story should incite your rage as the memory of this experience reignites mine.

Please, someone tell me why we are still challenged with identifying and treating pain in the elderly, particularly those with dementia. How can we simultaneously make great strides in reducing the use of psychotropics in skilled nursing facilities and yet not tackle a probable reason for their misuse in this population – to treat symptoms that are best treated with an analgesic?

Continue reading Steven Littlehale’s guest column on