Written By: Rudi Lamy, MLS, MAS, Consultant to the Peter Lamy Center on Drug Therapy and Aging
Pain in Older Adults: A Lamy Center Seminar
On Jan. 11, I was fortunate to be present at a seminar sponsored by the Lamy Center, in conjunction with the Palliative Care Collaborative at the School of Pharmacy, titled, “Pain in Older Adults and the End-of-Life: Opening Pandora’s Box.”
The physical attendance was so good that the hall was filled to almost overflowing. And, while I am not privy to the specific numbers, I am reliably informed that the online attendance was also quite good for this inaugural event.
The seminar boasted presentations from distinguished faculty and health care professionals from the School of Pharmacy, School of Nursing, and the Johns Hopkins Hospital. You can find a detailed review of the seminar written by fourth-year student pharmacists here on this blog.
Complications: Pain, Home Care, and Dementia
At the seminar, the focus was on pain and the end-of-life. In other words, pain as it relates to the death and dying of the physical body of the older adult. You might then ask, why was I there? It’s true, while I am a caretaker for an older adult of 79 years, I am not focused on the pain and death of her body. However, I am, in fact, facing a similar version of those issues.
I am a caretaker for a woman whose body may be weakening, but whose mind is dying, and taking with it her memories, her personality, and possibly — if you are in a philosophical sort of mood — her soul. I’d be hard-pressed not to describe our situation at home as analogous to end-of-life issues.
There are those, I suppose, who would say that — with apologies to Master Shakespeare — a dementia, is a dementia, is a dementia. And, in a very broad sense, that it true. But, each patient is different. They have different physical characteristics. They have differing life experiences. They live in different parts of the world. And, their financial circumstances are never exactly the same.
Lessons for Professionals and Caregivers Alike
Over the past nine years, I have come to understand that it is crucially important that all those good souls who help the family caregiver — the health care personnel, the home care assistants, and anyone and everyone else — understand exactly who it is that they are helping the familial caregiver care for. So, imagine my happy surprise when I saw that one of the sessions included in the seminar, titled “Strategies in Establishing Patient-Centered Pain Management Goals,” focused on that very topic: encouraging health care professionals to include patients and their caregivers in establishing goals for pain management. From one caregiver to another, I urge you to do your research and find a health care team that takes the time to listen to your concerns and incorporates your thoughts into the care that they provide.
However, your health care team can only take your preferences into consideration if you make those preferences known. Never forget that you are your loved one’s best health care advocate. It is incumbent upon the primary caregiver — that loving, loyal husband, wife, daughter, or son — to make sure that everyone who provides any health care services is well aware of the specifics of his or her individual patient with dementia.
And, just as important, they must understand that you, as the primary caregiver, have to be considered as part of a two-person “patient” — a sort of binary system if you will. For instance, as my wife’s caretaker, I am aware of the complications that both prescription and over-the-counter pain medications can have on her body and mind. Because, although she does not remember, we have experienced significant complications and adverse effects, both cognitive and behavioral, and I am able to share this knowledge with health care professionals on her behalf.
As caregivers, both professional and familial, we cannot — must not — focus only upon the physical aspects of the illness that afflict the patient with dementia. The psychological and emotional traumas will often become apparent first. Their minds can fail long before their bodies do. That person you grew up with, or married, or partnered with can die and be long gone even as their physical presence is still with you.
And that’s how it’s been with us. Through the days and months and years, I’ve watched my wife fade away towards not just the end of her physical life, but also the end of her psychological and spiritual lives; and the end of our life together as well.
Thanks for reading,
Influenza: An Addendum
Some of you may recall that I published a post about the flu some time ago. You can view that post in its entirety here.
You may all also be aware of the news reporting on the flu “epidemic” in the United States these past two months.
So, I thought you might want to review “This Year’s Flu Shot: What You Need to Know,” from RxWiki. Likewise, new guidelines have been published related to the risks of getting a flu shot for individuals with egg allergies. You can learn more about the new guidelines in “Egg Allergy? Flu Shots May Be OK,” from RxWiki.
You can also find a great deal of information about the flu and its current status with the general population on the Centers for Disease Control (CDC) web site at: https://www.cdc.gov/flu/index.htm. The CDC web site includes press briefings as well as recommendations for fighting the flu.