Pain treatment can take different forms than meds
Friday November 30, 2007 -- Deron Hamel
Over the years, Maplewood has been successful at decreasing psychotropic medications by better identifying pain issues in residents, says Anneke Schagen, a registered nurse at the Brighton long-term care home.

In the past, residents in long-term care who were exhibiting agitation were often treated with psychotropic medications as a first reaction. Over time, however, the long-term care sector has come to understand that behaviours are not always caused by cognitive issues.

When residents appear agitated, it’s often because they’re in pain.

Schagen adds that once pain has been identified as the cause of agitation, there are alternatives to medication which can be taken. Taking measures to ensure comfort, such as pressure reduction or changing surfaces on beds, she notes, can often alleviate pain in residents.

“If we can manage the pain without medication first . . . that’s the way I prefer to go,” says Schagen. “(Medications) are wonderful when they’re needed, but if there’s another choice, that would be my preference.”

Medications can dull a person’s senses and as a result confusion is a side effect of many medications. Because of this, Schagen says she prefers alternatives when they are available and suitable to use.

“I (want) residents to have as much clarity in their day as possible,” she says.

Schagen says when a resident with dementia exhibits agitation, pain is the first thing that should be looked at as the cause. A person cannot be expected to behave well if they are not comfortable, she notes.

“It has always been my thought to look at basic needs first,” she says. “If those needs aren’t fulfilled, then a person can’t be settled.”

In some cases, residents’ family members become involved in the process of treating pain in their loved ones.

One Maplewood resident, who has multiple sclerosis, is participating in reflexology treatment with his family members. The man’s family members will come to visit and spend time massaging his feet with a special instrument, which, so far, is having positive results.

“They feel there’s a good effect with it,” says Schagen.