Pain As a Challenge in Nursing Home Residents with Behavioral and Psychological Symptoms of Dementia

Overview

Journal Clin Interv Aging

Publisher Dove Medical Press

Specialty Geriatrics

Date 2018 Jun 7

PMID 29872283

Citations 9

Authors

Tomasz Nowak

Agnieszka Neumann-Podczaska

Ewa Deskur-Smielecka

Arkadiusz Styszynski

Katarzyna Wieczorowska-Tobis

Affiliations

Soon will be listed here.

Abstract

Introduction: In patients with dementia, observational scales are recommended for use in the assessment of pain. Unfortunately, their application is rare, and as a consequence pain is frequently underdiagnosed and undertreated in these types of subjects. Thus, the aim of the study was to assess analgesic treatment in nursing home residents with cognitive impairment and to delineate the relationship between pain and behavioral and psychological symptoms of dementia.

Patients And Methods: The research was conducted in 2 nursing home facilities in Wielkopolska, Poland. The analyzed group consisted of 96 residents (78 female) with moderate and severe cognitive impairment in whom pain was assessed with the Abbey Pain Scale (APS) and agitation with the Cohen-Mansfield Agitation Inventory (CMAI). Thereafter, medical files related to drug prescriptions were analyzed.

Results: Analgesics were consumed by 33 individuals (34%); 24 (25%) received regular pain treatment and 7 individuals (7%) - as when needed pain treatment. A relationship was found between the APS and CMAI (=0.45, <0.0001). Subjects with a higher CMAI received sedative drugs more frequently (<0.001), and despite having a higher APS (=0.001), this did not correlate with higher analgesia.

Conclusion: Our study suggests that pain can be an important underlying cause of behavioral disturbances in older subjects with dementia. In order to reduce their frequency and to avoid excessive usage of sedatives, proper pain assessment and management are essential.

Citing Articles

Ethical Obligation of Adequate Pain Management in Long Term Care Residents with Dementia.

Ewy D Kans J Med. 2024; 17:87-89.

PMID: 39091369 PMC: 11291185. DOI: 10.17161/kjm.vol17.22135.

Association Between Pain and Fall Worry Among Community-Dwelling Older People With Cognitive Impairment in the United States.

Zhou Y, Choi N, Sadak T, Ghosh N, Phelan E Innov Aging. 2023; 7(10):igad100.

PMID: 38094927 PMC: 10714914. DOI: 10.1093/geroni/igad100.

Prospective study of pain and patient outcomes in the emergency department: a tale of two pain assessment methods.

Ku N, Cheng M, Liew C, Chen Y, Sung C, Ko C Scand J Trauma Resusc Emerg Med. 2023; 31(1):56.

PMID: 37872561 PMC: 10594810. DOI: 10.1186/s13049-023-01130-9.

Pain and Its Management in Patients Referred to a Geriatric Outpatient Clinic.

Rutkowski K, Wyszatycki M, Ejdys K, Hawryluk N, Stompor M J Pers Med. 2023; 13(9).

PMID: 37763134 PMC: 10532457. DOI: 10.3390/jpm13091366.

Pain Assessment for Individuals with Advanced Dementia in Care Homes: A Systematic Review.

Felton N, Lewis J, Cockburn S, Hodgson M, Dawson S Geriatrics (Basel). 2021; 6(4).

PMID: 34698157 PMC: 8544573. DOI: 10.3390/geriatrics6040101.

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