Dad notoriously whines about being too ouchy to do stuff while at home, and then tells his doctor his pain level is something ridiculous like a three. Out of ten.
I’m like, dude, if it’s a three, you wouldn’t be living here. A three means you hurt a bit, but you can do everything all by yourself just fine. And he’s like, oh, well, nah, I can’t be doin’ all that.
So I started a pain journal, and we have this routine:
- I ask him to rate his pain.
- We go over ADLs and I-ADLS.
- We check his responses to this handy-dandy chart.
- He almost always ups the score at least three or four points.
- We discuss strategies for him to have a day worth living.
First let’s review the Instrumetnal Activities of Living independently, called the I-ADLs. If he can’t fully do these himself, then his pain is at least a four and/or other things are going on such as dementia. Note that these things start with “does he”. It may be important to note that he can but won’t, and why.
Does he:
- manage his own finances?
- remember medical things like doctor appointments, taking medications, and doing his home physical therapy regimen?
- plan and prepare his own meals without safety concerns?
- do basic housekeeping such as sweeping, dusting, and picking up trash?
- do his own grocery and other shopping?
- use the computer and/or telephone to successfully communicate?
- manage his own transportation, including driving or arranging rides to appointments?
- take care of other house-things such as feeding and pottying his dog, and water the plants?
- participate in hobbies and/or social events?
Here are the Activities of Daily Living or ADLs. If he can’t fully do these, then the pain level is at least a seven:
- Eating, can he feed himself; why not?
- Bathing, can he clean himself, to what degree; why not?
- Dressing, can he dress himself, to what degree; why not?
- Mobility, can he move around to everywhere he needs to go; why not?
- Continence, do poop and pee stay where it needs to until he can get to where it oughta go; what doesn’t make it, to what degree, and why?
- Toileting, once he gets to where the continence items need to go, can he fully use it himself; what needs help, and why?
My next step is to put all of this into a quick online survey that can be tracked and shared with his doctors if need be. Along with things like which meds he took, food consumed, and anything else that seems pertinent such as inclement weather or loss of a friend.
Man, being old is a lotta work. No wonder I wanted to die young. That was a major fail.