Caregiver Tips: The Pain of Shingles – so much worse for the confused, elderly with Alzheimer’s


It’s 2 o’clock in the morning and I can’t sleep. I’m thinking about my dear friend who was just diagnosed with shingles. And a particularly severe and painful attack involving not only her skin and nerve endings but her eyes.

“Attack” is really a good way to refer to something so painful and therefore so debilitating. Talking to Shari and hearing how she is suffering – she and I could not help but think of those we care for. It is so like Shari in her suffering to think of those who due to their dementia are living in the moment.

They don’t think of the past and remember when they had Chicken Pox as a child, that led to the pain they have now. The Chicken Pox virus, after the lesions are gone, goes down your nerve endings where it stays until either stress or being exposed to someone with shingles brings the virus back to the surface.

Living in the moment the Alzheimer’s patient with shingles doesn’t see the future when this will be resolved. Or live with the hope when this pain will be gone.

Signs of pain in someone with Alzheimer’s disease:
Increased restlessness or thrashing
Rubbing or pulling at a body part as though they would like to tear it off and throw it away
When the blister starts to drain it is extremely itchy
Worsening of any previous negative behaviors
Facial expression; frowning, grimacing, sad expression, looking worried, crying.

Keep in mind that when the skin lesions are gone the patient may still have pain, in some cases for even years, and be unable to tell anyone.

So it is now 2:30 a.m. and I am thinking of my friend. I know the wee hours of the night well, having worked the night shift for over 10 years of my career. I know that pain is so much worse at night when people and distractions of the day are gone. Now I sip my Earl Grey tea and think of my dear friend, I think of all of the faces from the past and I think of all of you – the caregivers, families, healthcare workers and the suffering.

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