Caring for Patients with Dementia and Pain
Updated: Oct 27, 2020
Each one of us can relate to the difficulties created by minor and major physical trauma and pain. These consequences are even more pronounced among one of society’s most vulnerable populations: patients with dementia. Patients with dementia have pain-producing conditions that are manageable by both pharmaceutical and non-pharmaceutical means, but unfortunately, their pain often goes undetected. For example, although pain relief is an integral part of end-of-life care, patients with cognitive impairment receive less treatment for pain during this important time. In addition, because the “gold standard” for pain assessment is self-report, as the ability to communicate verbally declines with increasing dementia, the assessment of pain becomes even more challenging.
Undetected and untreated pain among a patient with moderate to severe dementia can lead to a host of unwelcome consequences. This pain affects patients in multiple ways including lowered mood, agitation, lessened independence, decreased quality of life, and behavioural outbursts such as aggression, and lessened social participation. Even among those with less severe cognitive impairment, pain is related to depression, fewer pleasant activities of daily living, and impaired social processes.
What can we do as caring professionals (be it as nurses, care aides, physicians, or paramedical staff, e.g., physiotherapists, psychologists)?
We can advocate for patients and intervene with helpful strategies for pain identification, assessment, and management.
We can work towards aiding some of the accompanying problems, such as depression, when necessary.
Getting to know the patient is vital in being able to interpret signals that could relate to pain. Understanding the patient’s life history and family can allow us to determine changes in behaviour, which can aid in pain assessment.
Using observational tools such as the PACSLAC-II can be helpful in pain assessment.
Multidisciplinary collaboration is necessary for new computerized automatic pain assessment systems to come into practice.
Indeed, it is our privilege to advocate for these patients and work towards decreasing systemic barriers and creating a more easeful, pain-free journey.
How You Can Help?
Would you like to share your thoughts on our See Pain More Clearly initiative and the use of social media to mobilize knowledge about pain in dementia?
We are looking for participants to participate in a study to evaluate the effectiveness of the #seepainmoreclearly social media initiative to mobilize knowledge about pain in dementia.