The pain of a heart being broken: pain experience and use of analgesics by caregivers of patients with Alzheimer's disease.

Ewa Wojtyna,Katarzyna Popiołek

doi:10.1186/s12888-015-0571-1

Abstract

BackgroundIt has been observed that psychical suffering (e.g. the feeling of losing a significant person) tends to reduce the physical pain tolerance threshold, as well as to increase the subjective sense of painfulness. The purpose of this study was to assess pain sensation among a group of caregivers of patients with Alzheimer’s disease, and to determine the psychological factors (emotional and relational) that contribute to both pain perception and coping with pain via the use of analgesics.MethodsThe study comprised 127 caregivers of patients with Alzheimer’s disease. Questionnaires were used to elicit pain intensity, strength of emotional relationship between caregiver and patient, sense of painfulness of the loss experienced, depression level, and somatic ailments.ResultsA large majority (87.4 %) of participants reported pain complaints, while 93 % took analgesics without a doctor’s recommendation at least once a week; 8 % took painkillers daily. The strongest predictors of both perceived pain and tendency to use analgesics were sense of loss and painfulness of loss in relation to the patient’s deteriorating condition.ConclusionsThe pain experienced by caregivers may be connected to social pain resulting from the experience of losing someone they are close to. Caregivers may resort to excessive use of analgesics as a pain-coping strategy.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-015-0571-1) contains supplementary material, which is available to authorized users.

Highlights

It has been observed that psychical suffering tends to reduce the physical pain tolerance threshold, as well as to increase the subjective sense of painfulness
Our study shows that many caregivers of Alzheimer’s disease (AD) patients report pain complaints and that they frequently take analgesics without consulting a doctor
The sense of loss and painfulness of loss turned out to be the strongest predictors of pain intensity and of using analgesics. This result confirms our hypothesis that pain sensations are relatively intensified and that the use of analgesics is more frequent among this subset of caregivers of AD patients

Summary

Introduction

It has been observed that psychical suffering (e.g. the feeling of losing a significant person) tends to reduce the physical pain tolerance threshold, as well as to increase the subjective sense of painfulness. Our research to date has demonstrated that an important predictor of depression and exhaustion among people performing as caregivers is the type of bond they have with the person for whom they provide care: the stronger the relationship, Wojtyna and Popiołek BMC Psychiatry (2015) 15:176 the greater the emotional exhaustion of the caregiver [6]. More profound feelings of loss connected with the deteriorating psychophysical condition of the patient and changes in her or his personality are associated with caregivers’ intensified symptoms of depression and diminished sense of personal achievement related to providing the care. It is interesting to note that a more profound sense of loss, coupled with strong positive emotional bonds and positive experiences with the patient when she or he was still healthy, has been associated with intensified somatic, rather than affective, symptoms of depression [7]

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