Pain can become a habit. When nursing care is limited to painful procedures and no positive experiences are provided for days and weeks, an approach by anyone will be perceived as a threat. The recent solution to this problem has been placing them in a stupor with antipsychotic medications.
Positive sensations several times a day are an alternative with fewer medical complications and perhaps reduced costs. The labour and medication costs will need to be evaluated. With progressive mental disorders, we need better data about how long people live once they enter ACL 1 and adequate nutritional intake becomes a major challenge. The natural course of the dementias from ACL 4.4 and below could benefit from prospective, longitudinal studies.