Pain is often not recognised when it comes to dementia and there is little understanding of how people with dementia are affected not only mentally but physically. Symptoms for instance such as aggression and agitation are often put down to dementia when in fact they may be due to e.g. an infection. See ‘Support to live a good life with dementia’ Nursing Standard 2 July 2014.
And more people living with dementia also have cancer as the risk of both conditions increases in older people and more people are living longer. The first ever UK Macmillan dementia nurse consultant Lorraine Burgess says ‘all too often dementia is blamed when patients become distressed or agitated when in fact the reason someone is behaving like this is becauses they may be in pain or discomfort from the cancer and/or its treatment side effcts but can’t articulate this. The result is they suffer in silence.’ Many healthcare professionals are unaware of the issues. She also points out that dementia patients are at greater risk of developing delirium with symptoms like agitation, restlessness and hallucinations and the risk increases if they go into hospital for treatment There are many causes of delirium but the commonest ones are pain, dehydration and lack of nutrition, very relevant to dementia patients with cancer who may have stopped eating and drinking because they have untreated pain (see ‘Consultant role bridges the gap’ Nursing Standard online 26 August 2015 https://rcni.com/nursing-standard/features/consultant-role-bridges-gap-56166.) Always consider pain as a possible cause when it comes to symptoms, never underestimate its impact and make sure it’s properly treated says Lorraine.