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Chronic pain and dementia. Do not despair we can help!

I have some exciting news to share, I have been appointed Senior Consultant to the Nightingale Dementia Consultants Board.

This is a new training initiative set up by Dr Daniel Nightingale and leading hypnotherapist Steve Miller. 

Dr Nightingale has a great track record in using non-drug treatments with people with dementia and is the author of A Clinicians Guide to Non Pharmacological Dementia Therapies. He now wants to get his expertise used more widely and wants to put hypnosis for dementia on the global map and, together with Steve Miller, is launching a hypnotherapy diploma on the subject.

Diploma in Applied Hypnosis and Brain Health Coaching for Dementia

The diploma will create expert hypnotherapists who can help in this area and will also be a guarantee of quality. I am hoping that it will help all of us who work to offer drug-free solutions. If we can get better access to GPs and get them to recommend our treatments that would be a great step forward. 

This new diploma is designed to help people with early to mid-stage dementia.

My role will be to advise on a number of areas which affect people living with dementia. These will include depression, sleep disorders and pain management. I have had a long-term interest here, as there is some evidence that people with chronic pain may be at greater risk of dementia. Here is one of the academic studies if you are interested. https://www.ncbi.nlm.nih.gov/pubmed/28586818 

The key finding seems to be that chronic/persistent pain leads to accelerated memory loss and this may lead to dementia. It is not clear why this should be, but it may be that chronic/persistent pain so constrains life that it has serious effects on brain health. My instinct tells me that if someone stops going out, loses interest in the things which once delighted them in the world, doesn’t move and shows no interest in ideas, culture and fun then decline is more likely. It is these things which keep the brain active and the human spirit alive. Stop them and decline is likely.  

Can hypnotherapy help with dementia?

The areas I will be consulting on for the new diploma are ones in which I work already. Being able to apply my knowledge and expertise more widely is very exciting. 

You may be wondering how hypnosis can help people with dementia and I know some people are sceptical about this. 

Because we need to convince those living with dementia, and their loved ones that this is a worthwhile avenue to explore, I thought it was worth talking a little bit about pain and dementia here and explaining how hypnotherapeutic techniques can help. 

Pain and early dementia

I am sure that many of the ways I help all people with chronic pain can be adapted for use to people with early to mid-stage dementia.

It is important that you know that dementia itself does not cause pain. But as anyone who has any experience of people who suffer from this condition will know that the story does not end there. One of the saddest aspects of dementia is that sufferers become less and less able to take care of themselves and keep themselves safe.

Falls and accidents are common, and of course they can cause pain. On top of this, dementia mainly affects older people, and they will be vulnerable to that pain we often think of as the ‘normal’ pains of old age. There are physical reasons why we can suffer more pain as we age. The sinews and cartilage of our joints become less supple and this can hurt. If we are still able to care for ourselves, we can take action to control or even reverse this. Physical exercise, stretching and moving help here. Developing good mental habits is important as well. 

But if someone has dementia it can become much more difficult to do things like this. It is not impossible, but we need targeted interventions and expertise to achieve it, and this is sadly lacking at the moment. Hopefully, Dr Nightingale’s diploma will change this. 

We are going to be developing these areas in a lot of detail over the next period and I am sure we will take practice in this area forward. 

It will be building on what we do already. If you are affected by pain and dementia, I think that a good psychologist or cognitive hypnotherapist with a specialist focus on managing pain can help you. 

What a hypnotherapist can do for a person with dementia

Here is what I mean.

The first big challenge is to identify pain. Even if a person with dementia still has the power of speech, they may have lost the mental capacity to inform carers, friends or family that they are in pain. Watching for signs of pain is important. Changes in moods may be an indication, as may changes in activity levels. If a person with dementia becomes withdrawn or angry or if they do not want to do their usual activities it is worth checking if they are in pain. Using visual pain scales can be a big help here. 

A dementia sufferer may not have a memory of pain or a way to integrate this into their experience. This can increase anxiety and fear. So sometimes the best way to start is by dealing with these. 

Creating safe places in the imagination, which the person with dementia can ‘go to’ in their mind is a good place to start. Using breathing exercises to calm the system is also useful.   

Another area where hypnotherapeutic techniques may be of help is accessing memories. Memories may have become a patchwork. Frequently a distant memory will be clear, when what happened a few moments ago is not. Using the clear and pleasant memory, even if it is from sixty years ago can be useful in soothing pain. Memory can be a ready-made distraction, there to soothe pain away like a warm bath. I believe that using a gently state of hypnosis to allow the person with dementia to experience that memory as strongly as possible can be an excellent way of helping them ease pain. And it will often be enjoyable in itself, which is a lovely thing for the person with dementia and for the carers, family and friends around them.

With my colleagues, I will be developing these techniques and the theories behind them and passing them on. If you want to share your experiences, I  would love to hear from you.  

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