The older population is most at risk with various medical conditions which affect their health negatively. The older people are at risk of diseases such as coronary heart disease, cardiovascular diseases, cancer of the lungs and breast, COPD, prostate cancer and dementia. Both young old, middle old and Old-old adults are at risk. Pain in older persons with dementia has often been under reported due to poor assessment skills. Studies have shown that dementia patients receive limited care due to unrecognizable symptoms of pain leaving them to suffer without any medicare, (Corbet et al., 2014). In a study by Oosterman et al., (2014) shows that adults with dementia made few true positives, less accurate negatives and high false negatives. Most of the adults were young old and above and those with multiple disease correlated with dementia like Alzheimer’s disease.
In any disease diagnosis, pain is the common factor affecting diseases management and patient quality of life. Pain assessments among these patients are often assed using observational tools, (Delaine & Thomas, 2016). The impact of pain in dementia is a complex issue; dementia is characterized by effects on neuro pathological diagnosis. Assessment of pain is however challenging in that loss of ability to communicate leaves the patient in chronic in pain without proper assessment for appropriate care. Chronic pain dementia can be as result of persistent underlying medical condition.
Pain is often under reported among adults, and screening methods used don’t critically assess the extent of the pain as they are already unable to inform others that they are in pain, (Achtenberg & Lautenbacher, 2017). Young Old adults over 60 years of age are prone to lower back pains are often encountered due to physical, mental and psychosocial changes in their bodies. Age related factors have compounded the occurrence of pain among the adults. Multiple risk factors including ethnicity, gender and genetic have associated with pain increase, (Wong, Karppinen & Samartiz, 2017).
Challenges in assessing pain is however complicated with advanced dementia compared to people without dementia. Nurse’s failure to report pain has often been plagued with under reporting due to poor assessment techniques used. Visceral pain has always been associated with medical conditions in the muscular region, GI and cardiovascular pathways, (Allely, n.d).
As a nurse, pain management forms key provision in end of life care, acute nursing care centers and home care based treatment often are not fully supported and allocated few resources to effectively manage pain in older age in advanced dementia. Mentoring of nurses amongst themselves and establishing needs assessment periodically coupled with interactive based learning of patient centered care using the principles of human value, individualized care, perspective view and social view could help in improving and promoting value of care to the patients. As a nurse theirs is need for continuous professional development in nursing field and pharmacology as information and knowledge depth change daily, which can have positive impact on pain management practice in dementia.
Achterberg, W., & Lautenbacher, S. (2017). Editorial: Pain in Dementia: A Distressing Combination of Several Factors. Current Alzheimer Research, 14(5), 468-470.
Allely, C. S. Pain in individuals with dementia: is the concept of pain no longer intact?
Ammaturo, D. A., Hadjistavropoulos, T., & Williams, J. (2016). Pain in Dementia: Use of Observational Pain Assessment Tools by People Who Are Not Health Professionals. Pain Medicine, pnw265.
Corbett, A., Husebo, B. S., Achterberg, W. P., Aarsland, D., Erdal, A., & Flo, E. (2014). The importance of pain management in older people with dementia. British Medical Bulletin, 111(1), 139-148.
Oosterman, J. M., Hendriks, H., Scott, S., Lord, K., White, N., & Sampson, E. L. (2014). When pain memories are lost: a pilot study of semantic knowledge of pain in dementia. Pain Medicine, 15(5), 751-757.
Wong, A. Y., Karppinen, J., & Samartzis, D. (2017). Low back pain in older adults: risk factors, management options and future directions. Scoliosis and Spinal Disorders, 12(1), 14.
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