Pain Management in Those With Dementia

            With a growing elderly population and an increase in nursing home occupancy, it is important we place more focus on how we treat pain in those with dementia. The current systems for pain management are not always held to professional standards and are sometimes not used at all in clinical settings. Pain management is difficult in those with dementia because they are not always able to communicate clearly and their actions are often mistaken as a “behavior” rather than being in pain. It is also difficult for dementia patients to be placed in hospice care, preventing them from the comfort care and end of life medications often given to others with terminal illnesses. Our ethics topic focuses on the facts and implications of current pain management in those with dementia and what needs to be improved in the near future to provide the best comfort care for those nearing the end of life.

            It is predicted that by 2025, nearly 115 million people will have dementia. Today, only 11% of those in hospice programs have dementia, showing the major gap in treatment plans between those with and without dementia. This is not only because hospice programs require a diagnosis of death within six months, but almost all pain assessment tools rely on self report as their only measurement. People with advanced dementia lack the ability to communicate effectively and comprehend complex questions, leaving it difficult for them to tell someone they are in pain or where the pain is located. This often results in frustration of the patient and acting out, a sign characterized as “behavior” by nursing staff and often treated with antipsychotic medications rather than pain medications. Talking about these issues is imperative. Vulnerable populations in healthcare, especially those with mental illness, need others to advocate their rights for them. We need to make sure these people are getting the best professional care as possible even if they cannot communicate to us.  written by students

Main Article:

Barriers to the Management of Pain in Dementia Care 

Others Articles to Read:

When a Patient Nears the End, a Feared Therapy Can Also Comfort 

End-of-Life Care for Patients with Advanced Dementia