Pain management in elderly patients is a challenge, and when elderly patients suffer from dementia, pain treatment becomes even more difficult because of the communication problems with such patients. Almost 50 percent of the elderly patients admitted to hospitals complain of pain, and of these 20 percent complain of severe pain (Monroe and Mion, 2012). However, research has documented the under-detection and under-treatment of pain in patients with dementia (Cunningham, McClean, and Kelly, 2010). It has also been found that systematic use of analgesics in elderly dementia patients can reduce their level of agitation within acute care settings (Hirsch, 2011). This study attempts to develop an assessment tool in an acute care facility to assess the degree of pain experienced by elderly dementia patients and establish a set method for their treatment.
Today, there is extensive research to formulate a tool that will enable efficient pain assessment in elderly patients suffering from cognitive impairments. Nevertheless, it has been found that the amount of analgesics consumed by such patients is far less than other elderly patients (Cunningham, McClean, and Kelly, 2010; Barry et al., 2012). Moreover, nursing home managers continue to face challenges in dealing with pain assessment and management in such patients (Barry et al., 2012). It is necessary that pain in elderly dementia patients should be treated by considering their psychological and behavioral indications. However, a lack of knowledge and training can affect the ability to gauge the degree of pain in such patients (Barry et al., 2012). Moreover, administration of pain medication based on observations and pain assessments cannot completely replace systematic assessment of unmet needs (Hirsch, 2011). It is possible to assess the pain suffered by a dementia patient by establishing a communication system with him or her as well (Cunningham, McClean, and Kelly, 2010). Thus, while there is awareness that pain assessment and management in elderly patients with dementia is a issue and even though research on the subject is carried out extensively, the fact that education of the nursing staff can help this situation has not been openly advocated.
It can be concluded from the facts presented above that basic problem in the treatment of pain in elderly patients with dementia is the lack of adequate and systematic training of the nursing staff. The caregivers should not only be possessing extensive knowledge about the pain experienced by such patients but also be able to effectively diagnose the pain and administer accurate medication, by establishing a communication process with the patients. The caregivers should be informed and trained about the types of pain experienced by various elderly patients as well. For instance, a nurse should be able to diagnose if the pain experienced by a patient is idiopathic, neuropathic, or nociceptive in nature. The patterns in which these patients communicate their pain must be studied and discussed to gain a better understanding of the issue. Finally, caregivers must learn to appreciate the fact that the psychological aspects of pain are far more intense and complicated than the biological reflex reactions that are taught in medical books. Similarly, they must have knowledge of the patient’s history because factors such as depression can increase the intensity of pain experienced. The objective of developing a pain assessment and management tool for elderly patients with dementia should be to support such patients by providing them the comfort to improve their quality of life.
BARRY, H.E., PARSONS, C., PASSMORE, A.P. and HUGHES, C.M., 2012. An exploration of nursing home managers’ knowledge of and attitudes towards the management of pain in residents with dementia. International journal of geriatric psychiatry, 27(12), pp. 1258.
CUNNINGHAM, C., MCCLEAN, W. and KELLY, F., 2010. The assessment and management of pain in people with dementia in care homes. Nursing Older People, 22(7), pp. 29–35.
HIRSCH, C., 2011. Systematic pain management reduced agitation in nursing home residents with dementia. Annals of Internal Medicine, 155(10), JC 5–9.
MONROE, TODD B,PHD., R.N.-B.C. and MION, LORRAINE C, PHD,R.N.F.A.A.N., 2012. Patients with Advanced Dementia: How Do We Know If They are in Pain? Geriatric nursing, 33(3), pp. 226.