Hostname: page-component-8448b6f56d-sxzjt Total loading time: 0 Render date: 2024-04-23T21:53:51.467Z Has data issue: false hasContentIssue false

Patient-centred assessment and management of pain for older adults with dementia in care home and acute settings

Published online by Cambridge University Press:  20 February 2014

P Newton*
Affiliation:
Centre for Applied Health Research, University of Greenwich, London, UK
R Reeves
Affiliation:
Centre for Applied Health Research, University of Greenwich, London, UK
E West
Affiliation:
Centre for Applied Health Research, University of Greenwich, London, UK
P Schofield
Affiliation:
Centre for Applied Health Research, University of Greenwich, London, UK
*
Address for correspondence: Paul Newton, Centre for Applied Health Research, Faculty of Education and Health, University of Greenwich, Avery Hill Road, London SE9 2UG, UK. Email: P.D.Newton@gre.ac.uk

Summary

Evidence suggests that there is a greater prevalence of pain, particularly chronic pain, in the older than in the younger population. This review looks at how dementia affects older people's ability to report pain, and indicates that pain is poorly assessed and managed in people living with dementia, in particular in care and acute settings. The review also reports findings from two recent studies looking at ways of improving the assessment and management of pain in acute settings. Multi-dimensional, patient-centred approaches to assessing and managing pain in those living with dementia are required, and future research should focus on innovative and practical approaches that can be applied in care home and acute settings.

Type
Review Article
Copyright
Copyright © Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1de Waal, H, Lyketsos, C, Ames, D, O'Brien, J. Designing and Delivering Dementia Services. Available at: http://onlinelibrary.wiley.com/book/10.1002/9781118378663 (accessed 11 November 2013).Google Scholar
2Department of Health (2009) ‘Living Well With Dementia: a national dementia strategy’. Available at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/168220/dh_094051.pdf (accessed 28 October 2013).Google Scholar
3National Institute of Health and Clinical Effectiveness (2013) Mental wellbeing of older people in residential care: quality standard consultation. Available at: http://www.nice.org.uk/guidance/index.jsp?action=folder&o=64372 (accessed 28 October 2013).Google Scholar
4Kitwood, T.The experience of dementia. Aging Mental Health 1997, 1: 1322.CrossRefGoogle Scholar
5Sabat, S.The Experience of Alzheimer's Disease: Life Through a Tangled Veil. 2001; Chicester: Wiley.Google Scholar
6Brooker, D. What is person-centred care in dementia? Rev Clin Gerontol 2003, 13: 215–22.CrossRefGoogle Scholar
7Hyochol, A, Horgas, L. The relationship between pain and disruptive behaviors in nursing home resident with dementia. BMC Geriatrics 2013, 13: 1314.Google Scholar
8Pickering, G, Jourdan, D, Dubray, C. Acute versus chronic pain treatment in Alzheimer's disease. Eur J Pain 2006, 10: 379–84.Google Scholar
9Elliott, A. Prevalence of pain in older adults. Age Ageing 2013, 42: 1.Google Scholar
10Edwards, RR. In Gibson, SJ, Weiner, DK (eds), Pain in plder persons, progress. Pain Research and Management 35, pp. 4565. Seattle: IASP Press, 2005.Google Scholar
11Sorkin, BA, Rudy, TE, Hanlon, RB, Turk, DC, Stieg, RL. Chronic pain in old and young patients: differences appear less important than similarities. J Gerontol 1990; 45: 6468.CrossRefGoogle Scholar
12Gibson, SJ. Older people's pain. Pain: Clinical Updates 2006, 14: 14.Google Scholar
13Kee, WG, Middaugh, SJ, Redpath, S, Hargadon, R. Age as a factor in admission to chronic pain rehabilitation. Clin J Pain 1998; 14: 121–28.Google Scholar
14Husebo, BS, Strand, LI, Moe-Nilssen, R, Borgehusebo, S, Aarsland, D, Ljunggren, AE. Who suffers most? Dementia and pain in nursing home patients: a cross-sectional study. J Am Med Dir Assoc 2008, 9: 427–33.CrossRefGoogle ScholarPubMed
15Schofield, PA. Talking to older people in care homes: Perceptions of their pain and their preferred management strategies. Results of a pilot study. Int J Disability Human Dev 2006, 5: 5359.Google Scholar
16Vallerand, AH, Hasenau, SM, Templin, T. Barriers to pain management by home care nurses. Home Healthc Nurse 2004, 22: 831–38.Google Scholar
17Abbey, J, Piller, N, De Bellis, A, Esterman, A, Parker, D, Giles, L, Lowcay, B. The Abbey pain scale: a 1-minute numerical indicator for people with end-stage dementia. Int J Palliat Nurs 2004, 10: 613.Google Scholar
18Simons, W, Malabar, R. Assessing pain in elderly patients who cannot respond verbally. J Adv Nurs 1995, 22: 663–69.Google Scholar
19Scherder, EJ, Oosterman, JM, Ooms, ME, Ribbe, MW, Swaab, DF. Chronic pain in dementia and in disorders with a high risk for congnitive impairment. Tijdschr Gerontol Geriatr 2005, 36: 116–21.Google Scholar
20Reeves, R, West, E, Barron, D. Facilitated patient experience feedback can improve nursing care: a pilot study for a phase III cluster randomised controlled trial. BMC Health Services Res 2013: 259.Google Scholar