Mom has a new friend—a stuffed kitten named Fred. She sits with him, strokes him, and sings to him. It is strange to watch her interact so intensely with this inanimate toy, but it seems to bring her comfort. She especially enjoys stroking his soft fur.
Touch is an important sense for Mom. We regularly hug each other and I am often the recipient of many kisses when we’re together. It is one of the ways in which we communicate our love. It allows me to show Mom tenderness when she cannot otherwise comprehend me. I can stroke her arm, cradle her head, softly tickly her hand, and in those moments, we are connected.
There are times when Mom refuses to be touched. If she is angry or feels we are manipulating her (e.g., forcing her to leave my dad to take a walk), she will reject the hand I hold out to her. She’ll even drop my arm when I try to lock arms with her. I usually wait a few moments then grab her arm again. It is imperative that we hold on to her. Mom has tripped more than once over the shallowest of steps.
Yesterday, a nurse tried to take Mom’s blood pressure. Despite her excellent bed-side manner, despite stroking Mom’s arm and talking sweetly to her, the nurse was unsuccessful. Mom swore in such pain when the cuff reached its maximum pressure, virtually ripping it off her arm. The nurse hastily removed it and decided we could live without that reading.
The last time I had my blood pressure checked, I don’t remember the pressure cuff as being painful, but I also knew what to expect—that the feel of the cuff tightening on my arm, the pressure it exerted, was finite. Whether Mom yelled out of fear or pain, it was clear that she was more sensitive to the experience due to her dementia.
In a 2015 article in the journal Pain,* an Israeli team at Tel Aviv University lead by Dr. Ruth Defrin analyzed previously published studies on how those with cognitive impairment dealt with pain.
“It appears that those with widespread brain atrophy or neural degeneration…all show increased pain responses and/or greater pain sensitivity,” Defrin explained.
An issue with dementia patients is that they are often incapable of indicating that they are experiencing pain, which poses a challenge for their caregivers and doctors to identify and treat. This has given rise to the false notion that dementia patients may actually have reduced pain sensitivity.
The simple touch of an unfamiliar individual can set Mom off. As can a snug waistband on her skirt.
The study found that those with mild to moderate Alzheimer’s were more sensitive to experiencing pain, while those with more advanced dementia were unable to communicate their discomforts. Researchers suggested using different methods to assess pain within this population, though the article did not specify what types of methods might work.
If we take the sense of touch in a more positive direction, games that involve tactile awareness can be enjoyable pastimes. Every object has a texture, a feel to it, which can stimulate Mom. Today we spent about an hour touching and sorting buttons of all shapes and sizes, placing them in a plastic tray then dumping them back again into their container.
Meanwhile, Mom holds conversations with Fred the Cat. His name and gender change frequently in Mom’s dialogues, but Daddy and I like the initial name she gave him.
“Let me know if he answers you,” Daddy quipped while we watched her interact with Fred.
Perhaps in her mind, he does.
Our cooking is only as limited as our imaginations. This recipe for stuffed peppers filled with a generous helping of sautéed vegetables certainly stirs my imagination with its colorful ingredients and charming end product. Guaranteed gluten-free and vegan-friendly.
Vegetable Stuffed Peppers
Choose small red, yellow and orange peppers for this dish. Their colors are as hearty as their sweet taste.
8-10 small red, orange or yellow peppers
4 carrots, diced
2 zucchini, diced
1 large onion, diced
3-4 cloves garlic, minced
2 cartons mushrooms, diced
½ cup parsley, chopped
¼ small cabbage, sliced
1 cup pumpkin, diced
1 tsp basil
Salt and pepper to taste
1 Tbsp olive oil
3 Tbsp tomato paste
1 Tbsp sweet paprika
In a large pot, sauté onions and garlic. When onions begin to brown, add carrots and cook for five minutes. Add other ingredients and continue cooking until vegetable mixture begins to soften. Remove from heat and let cool. Remove tops of peppers and fill cavity with cooked vegetables. Pour olive oil, tomato paste and paprika in the bottom of a large pot and mix. Place stuffed peppers in an upright position in bottom of pan, adding enough water to ¼ of the height of the peppers. Cover and bring to a boil then simmer for 30 minutes.
*“Some Alzheimer’s Patients Have Increased Pain Sensitivity,” June 1, 2015, PsychiatryAdvisor. https://www.psychiatryadvisor.com/neurocognitive-disorders/alzheimers-patients-more-sensitive-to-pain/article/417651/