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Nursing practice

Recognition and assessment of pain in people with advanced dementia

02 December 2024
Professional
02 December 2024
Volume 29 · Issue 12

Abstract

Pain is highly prevalent among older adults, equally affecting people with dementia and those without cognitive impairments. As dementia progresses, patients often develop difficulties in communication and it may impact their ability to self-report pain. Therefore, it is essential that nurses working with dementia patients understand how to recognise, assess and manage pain in this population. This article explores how pain affects people with dementia, especially those who cannot communicate their discomfort, and discusses how pain may present in these individuals. The article also offers guidance on assessing pain using observational tools. It highlights the importance of knowing the person and the valuable information provided by family caregivers. A hypothetical case study is used to consider some of the common issues in community nursing.

Dementia is an umbrella term for progressive neurological conditions that impact an individual's memory, functioning and behaviour (Alzheimer's Society, 2023). While there are over 200 causes of dementia, Alzheimer's disease, vascular dementia, dementia with Lewy bodies and frontal temporal dementia are the most common (Arvanitakis et al, 2019). Dementia is a global priority for action, due to the increasing number of people with dementia (World Health Organisation, 2017). Projections suggest that there are nearly one million people with dementia in the UK and over half of them are living with advanced dementia (Wittenberg et al, 2020). Dementia and Alzheimer's disease are reported as the leading cause of death in England and Wales (Office for National Statistics, 2023). While dementia is a major cause of death, it is the only such disease with limited treatments to prevent, slow, or stop its progression. (Alzheimer's Research UK, 2024).

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Alzheimer's disease
cognitive impairment
comorbidities
dementia
pain assessment and management