The Broken Hip in Room 14: The Importance of Personhood in Pain Management
Tom Kitwood was among the first to recognize the importance of personhood in the care of people with dementia. In simple terms, personhood in this context refers to the extent to which we perceive another person as a human being first as opposed to a patient with dementia first (i.e., a host of pathology). Do we value the person with dementia, as a social being, for who they are and for all that they have accomplished in their lives? Failure to ascribe such status to people with dementia can have deleterious consequences for their health care in general and for pain management in particular.
Our team has studied personhood perceptions in long-term care facilities and has found that staff members differ in the extent to which they perceive personhood in people with dementia. Perhaps more concerning was the finding that such perceptions of personhood affect care intentions. For example, having positive beliefs about the personhood of dementia patients was associated with a greater likelihood that staff members would say that they would select appropriate pain management interventions for people with dementia. This suggests that failure to acknowledge the personhood of dementia patients compromises clinical practice.
Mr. Jim Jones (not his real name) is not the “broken hip in room 14”. Mr. Jim Jones is a proud Canadian Veteran who risked his life for his country and who, after returning from the war, faced and overcame poverty. Mr. Jim Jones has been a loving and supportive husband to his wife and together they raised three children two of whom became successful entrepreneurs and one a prominent scientist. Mr. Jim Jones is known for being a loyal friend and a kind person who was always there to help others when they needed him. He now has dementia and still enjoys waking up to his favorite music every morning, human companionship and walking. He still loves chocolate.
Mr. Jones has broken his hip and is in pain. Staff members and family who are involved in his care always see him as the kind, caring and strong person that he has been all of his life. They know that he deserves the best care possible and like to see him smile.
Mr. Jones is not the broken hip in room 14.
- Thomas Hadjistavropoulos, Ph.D.
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 health care professionals and others to participate in a study to evaluate the effectiveness of the #seepainmoreclearly social media initiative to mobilize knowledge about pain in dementia.
Dr. Hadjistavropoulos is an international leader in the area of pain assessment in dementia and has shown leadership in the promotion of the health sciences at the local, national and international level. He is the Research Chair in Aging and Health, Director of the Centre on Aging and Health and Professor of Psychology at the University of Regina, Saskatchewan, Canada. He served as the 2007 President of the Canadian Psychological Association (CPA).