Understanding the Signs
Loss of empathy, impaired judgment, social withdrawal, impulsive behavior, compulsive behavior, forgetfulness, language difficulty, memory loss. This is what an Arbor Palliative Care patient began experiencing when she was only in her early 50s.
Today, at 64, she sits with her hands clenched, grinding her teeth, staring out her large front window. She can barely talk and requires assistance for just about everything. Her husband is her primary caregiver, relying on someone else when he needs a break, runs an errand or attends a support group for caregivers of individuals with neurological diseases.
“When I first met this woman and her husband, I was astounded,” Marie Heys, MS, FNP, BC, Arbor Palliative Care Nurse Practitioner said. “To be so young, and experience such disabling dementia is very sad. I told the woman’s husband that there was still plenty that could be done for his wife. I promised that I would ensure that she’s comfortable and that they receive support throughout the disease’s progression.”
During Heys’ first visit, she noticed that the patient was constantly grinding her teeth. When she asked the husband about it, she learned that it had been going on for awhile, and it really bothered him.
“To him, teeth grinding was like nails on a chalkboard,” Heys said. But, not only did the teeth grinding annoy him, it concerned him. The grinding was so fierce and continuous that the woman’s teeth were wearing down. She had already broken one tooth and probably swallowed it.
“I explained to the husband that his wife’s teeth grinding may be a sign of pain. Many people associate teeth grinding with anxiety, but in dementia patients, teeth grinding can be a way someone communicates discomfort. He was glad I recognized teeth grinding for what it was – a cry for help.”
Heys called the woman’s physician and suggested prescribing a pain medication to see if the teeth grinding continued. The physician was happy to have the recommendation and willing to try it to ensure his patient’s comfort. Heys spent time educating the patient’s husband on the medication and addressing his concerns.
“It can be extremely helpful for families and physicians to have another layer of support,” said Heys about her role with Arbor Palliative Care. “Our primary focus is pain and symptom relief to enhance a person’s quality of life. We recognize signs of distress that others may not, and we dedicate the time to educate and discuss what is really important.”
Arbor Palliative Care’s recommendation worked – the patient’s teeth grinding has significantly decreased.
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