Psychosomatic pain associated with Alzheimers?

skarl

Hi all, 

Mom has been living with my sister and me since COVID last March. She is about to be 90. Her Alz is progressing fast. Started in March 2020 with her asking me (from her living room in Maryland) when we would be landing on our plane from London.  We are lucky to have an aide PT and thank god will be getting a night aide.

Yesterday something weird  happened. She woke up at 1PM and used her walker to get to the  bathroom, all well, then went back to sleep. Woke up at 4, cradling her left arm against her shoulder, shrieking that her arm and shoulder were broken. We have baby monitors every where but it's possible we could have missed a fall from her bed.  Wouldn't let us touch her, kept saying it was her fault because "Daddy told me not to climb the tree and I fell out." When I left the room, she was calling for "Daddy," and she thought I was her mother.

Of course we went to the ER, every time we went over a bump, she screamed in pain. They x rayed collarbone, arm, wrist, shoulder, hand, hips and did a CATscan (stroke) all normal.  By this time in the  hospital, she was holding my sister's hand with the bad arm, exhibiting no pain at all. Like she forgot about it.

Brought her home, all well. Put her in bed. She does have terrible back pain from an old surgery so put a lidocaine patch on back.  At 2 am she woke up complaining about pain. At 3 am she woke up moaning about pain and asking for advil. I asked where it hurt and she said shoulder/arm. Feel utterly helpless and at a loss.  

Has anyone ever heard about this kind of delusion before? Has anyone experienced it as a caregiver?  Best advice for what I should do?  Thanks so much, Susan

M1

Susan, that is an odd story.  I have one thought--sometimes a shingles outbreak will start with pain before there's any rash.  Watch for it, if you start to see redness or blisters in the area she says is hurting, call right away for a prescription (Valtrex or similar).

When I was an intern I treated an old man for chest pain/unstable angina for a week before his rash finally broke out along his chest.  We were all very rueful.  There are many similar stories of people being taken for gallbladder or appendix operations when pain preceded the rash.

MN Chickadee

It is possible for a PWD to hallucinate pain. There is a poster here who has explained how after ruling out all other causes of severe pain, an anti psychotic drug eventually took care of it. It sounds like it may be tied to some old memory from your mother's past.  I would exhaust all other causes first, though. You want to make sure it isn't a physical issue that can be fixed. It sounds like the ER was thorough. Perhaps consult her regular doctor and give it more time to see if it passes on its own. When she asks for pain meds perhaps give her a small amount of ibuprofen or even a placebo, like a tic-tac or vitamin and see if it helps. My LO complained of chest pain a lot for a while. After many trips to the ER and regular doctor and tests and scans everything was ruled out. After that we would give her half an aspirin and a Tums when she started getting worked up about it and that would make it go away, whatever it was. She stopped mentioning it after a few months.

(=Meow=)

I often wonder if some of the pain my mom feels is pychosomatic, BUT given that dementia patients are suffering from cognitive decline, it could be an old memory. You never forget severe injuries as they tend to be excruciating,  the experience fades with time as your brain *wants* to forget...but if someone's brain is breaking down, all sorts of things become possible.

skarl

Thanks for your thoughtful replies.  She has not mentioned the pain since that night.  We are doing a virtual visit with her Primary Care doc tomorrow. I love the suggestion about giving mom something like a Tic Toc and saying it's pain medication. Great advice!