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assessment of pain; assessment of pain in patients with dementia

Clinical manifestations: 1) facial expressions, grimmacing, tears, crying 2) vocalizations a) moaning, groaning b) outbusrts c) explicit expressions of pain 3) noisy breathing 4) body language a) spliting or restricted movement b) rigid or tense body posture c) rocking or pacing d) guarding 5) social features a) social withdrawal b) lability c) resistance to interventions d) aggression, combativeness e) consolability 6) loss of appetite, refusal of food 7) change in sleep patterns 8) confusion, irritability, delirium [2] 9) nausea & constipation from opiate use * observing behavioral manifestations of pain is the primary mode of pain assessment in patients with dementia [1] Management: - use a validated pain assessment tool [3,4]* * see Pain Assessment in Advanced Dementia Scale (PAINAD)

Specific

Pain Assessment in Advanced Dementia Scale (PAINAD)

General

clinical procedure

References

  1. Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013 - Geriatric Review Syllabus, 9th edition (GRS9) Medinal-Walpole A, Pacala JT, Porter JF (eds) American Geriatrics Society, 2016 - Geriatric Review Syllabus, 10th edition (GRS10) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2019 - Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022
  2. Bjoro K, Herr K. Assessment of pain in the nonverbal or cognitively impaired older adult. Clin Geriatr Med. 2008 May;24(2):237-62 PMID: 18387454
  3. McGuire DB, Kaiser KS, Haisfield-Wolfe ME, Iyamu F. Pain Assessment in Noncommunicative Adult Palliative Care Patients. Nurs Clin North Am. 2016 Sep;51(3):397-431. PMID: 27497016 PMCID: PMC4978178 Free PMC article. Review.
  4. Lewis Ramos V, Eti S. Assessment and Management of Chronic Pain in the Seriously Ill. Prim Care. 2019 Sep;46(3):319-333. PMID: 31375184 Review. https://www.sciencedirect.com/science/article/abs/pii/S0095454319300296?via%3Dihub