San Diego Elder Answers
Expert advice for people caring for a loved one

How do you know if your loved one is in pain?

September is Pain Awareness Month. Tragically, pain is often unrecognized and untreated. This is especially true for people who are unable to communicate well with words. Although up to 80% of older adults experience pain, those with advanced memory loss (the later stages of Alzheimer’s or other dementias) are unable to use their words to tell us. The result is unnecessary suffering.

While words may not be effective for communication—even when we directly ask, “Are you in pain?”—relatively sudden changes in behavior may signal that your loved one is hurting somewhere.

Suspect pain if you notice changes in your loved one’s:

• Breathing—becoming labored and noisy. As pain increases, breathing may become faster, including rapid, short breaths.
• Body language—sudden restlessness, maybe pacing or sleeplessness. Fierce, even aggressive hitting, pulling or pushing away is frequently a sign of more severe pain, as is curling up into a rigid ball.
• Ability to be soothed—the more severe the pain or discomfort, the less likely your loved one will calm down with simple reassurance or touch.
• Speech or crying out—this is the most obvious signal and includes soft moans or groans, escalating to repeated yelling or wailing when there is intense pain.
• Facial expression—a new look of sadness or fear, or a scrunched-up, grimacing face can indicate your loved one is experiencing pain.

Caring for someone who is unable to tell you with words about their pain requires extra vigilance on your part. If you sense “something is wrong,” get a doctor to diagnose the problem and recommend treatments. Alternatively, you can ask for a consultation with a palliative care physician. These specialists focus on the relief of pain in all its forms.

Is caregiving hazardous to your health?

When caring for an ailing loved one, it is natural to focus on issues related to his or her health. An unintended consequence, however, involves risks to your own health. For instance, family caregivers often forego doctor visits for their own checkups.

The major culprit is stress. Higher rates of physical, emotional, and mental health problems among family caregivers are most strongly associated with the stress of providing care. Research has found the more stressed you feel as a caregiver, the more likely you are to develop health problems of your own.

Stress, for instance, causes anxiety and depression, and also increases the likelihood of heart disease, diabetes, cancer, colds/flu, and other infections. Family members caring for a loved one with dementia (memory loss) seem to experience the most stress. Not surprisingly, they also tend to develop more health problems.

The best remedy is stress-relief activities. To keep yourself healthy and able to care for your family member over the long haul, write yourself a prescription for:

• Social time. Spend time with others simply for fun and relaxation. Make it a point NOT to talk about the person you care for.
• Exercise. Work off your frustrations and reinvigorate yourself physically. Or unwind mindfully through yoga or tai chi.
• Crafts and hobbies. Do what you love, whether it’s art, music, writing, gardening, cooking, painting, or some other creative pleasure.
• Religious/spiritual practice. If spirituality is a part of your life, make time for prayer or meditation and/or attend the services of your faith community.
• Support groups. Meet with others in situations like yours to laugh, cry, and share tips.
• Respite. Take a break from caregiving. It’s not selfish, it’s essential!

See the doctor for regular checkups. And make sure you keep your appointment!

The healing power of music

Can listening to calming music actually ease pain? Can singing silly songs make you happier? Researchers say this isn’t just a folktale—it represents some of the measurable effects of music on the mind and body.

Although it’s not yet clear exactly how music works its magic, studies show that it is strong medicine, both in the moment and as treatment over time. Among the benefits, music:

• Stimulates the brain. It can sharpen thinking and enhance recovery from stroke.
• Brightens mood. Music with a tap-your-toes, upbeat rhythm can ease depression, reduce anxiety, and create a more positive outlook overall.
• Calms the body. Music with a slower, gentler pace and melody can lower blood pressure, heart rate, and rate of breathing. It can even reduce the need for sedation in surgery.

Bringing music into your loved one’s life is simple.

• Listen to prerecorded music: Tune in a favorite radio station, play a familiar composer or a beloved album. If your loved one has dementia (memory problems), melodies from the past will bring the comfort of familiarity.
• Go to a concert: Researchers say live music is best. Listen to a friend play the piano or go to a performance in the park.
• Sing favorite tunes at home: If your loved one likes to sing, choose cherished hymns, folk songs, or popular tunes from your loved one’s youth.
• Experiment: Music is personal. Try different kinds of music, including soothing sounds of nature, and notice your loved one’s response. Happier? More relaxed? See what works for your situation.

You can also ask your doctor about music therapy. Much like physical therapists, music therapists work to relieve pain or support physical or mental healing, which they accomplish by guiding patients through musical experiences. Music therapy is most often available in clinics, hospitals, and rehab facilities, and may be covered by Medicare.