I was wondering If a patient has alzhiemers/dementia for (6yrs now) then they are in the middle of a manic episode, Yet within that episode is crying out in pain. The only way to assertain if they are REALLY hurt is to get an MRI right???
But then comes the problem of keeping them still during there episode in order to do a MRI to determine to problem. Medicate them before MRI? What If there blood pressure goes too low? Is that a risk most hospitals wont take? Especially since the patient has alz/dem? Do you get the MRI done??
And IF NOT... Call in Hospice and Then just give them comfort care?? and let them go NOT knowing if there ever REALLY was any pain to alieviate OR Do you think its the disease progressing to its end and making the patient "think" he/she has pain which Might not even have been there???
Jul 25, '12
How would an MRI help to find out if they are "really" in pain or not?
If they act like they are in pain, then I medicate accordingly (tylenol works well for lots of alz pts)
Is there something you aren't telling us?
Jul 29, '12
I also don't know how you think an MRI would tell if someone is in pain. Pain is subjective.
With a progressive/degenerative disease, there are plenty of arguments to be made for NOT getting an MRI. If these patients are confused and can't sit still, they'd need to be sedated. Is it really worth putting them through that to get a test to tell you something that you already know based on clinical assessments?
Aug 1, '12
The simple answer is no. Pain is subjective; get a pain and palliative consult (not hospice).
The OP could be talking about a fMRI which is used to study pain and analgesic effectiveness more objectively.
That being said, I have never ordered an fMRI as I would always refer to a HEENT or onc specialist before it came to that.