Researchers working in the field of dementia and cognitive decline
As many as 80% of older adults who live in long-term care facilities (LTC) suffer from pain; however, pain is often under-assessed and undertreated in this population. Despite the availability of effective pain assessment and management practices, clinical practice often lags from the research. Pain problems in moderate to severe dementia are often not recognized because cognitive and language impairments interfere with the ability of those with dementia to report their pain. In addition, pain in dementia may increase frequency of responsive behaviours such as agitation or acting out. Responsive behaviours, caused by pain, are often misattributed to psychiatric causes and treated with psychotropic rather than pain medications. Psychotropic medications have been shown to hasten death in individuals with dementia in LTC settings. Feasible guidelines for assessing and managing pain in dementia are available. In addition, regular use of tools that monitor non-verbal pain behaviours in dementia, like the Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC) scales, have been shown to reduce pain in older adults with dementia and decrease stress among the nursing staff who care for them.
Regular use of the PACSLAC scales have also been shown to increase the use of medications to treat pain and reduce the use of psychiatric medications. Our team will support researchers by granting free access to the PACSLAC scales and providing advice and information on research gaps, implementation science, and approaches to improve pain care among those with dementia.
We thank the Saskatchewan Health Research Foundation, Saskatchewan Centre for Patient-Oriented Research (SPCOR), Canadian Association on Gerontology, the Chronic Pain Network, the Alzheimer Society of Saskatchewan, AGE-WELL NCE and all other organizations and people who are helping us increase awareness of the problem of pain in dementia.