Pain Assessment in Dementia Patients in Hospital

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ABSTRACT

Identification of pain in the patient with late-stage Alzheimer's dementia is very challenging and complex. Pain is difficult to identify in the cognitively impaired patient and can manifest itself atypically. The main purpose of this research study was to present the best accessible evidence on the pain assessment in patients who have been diagnosed with dementia.

TABLE OF CONTENTS

ABSTRACTII

CHAPTER 1: INTRODUCTION1

Research Background1

Aims and Objectives2

Significance of the Study2

Structure of the thesis2

CHAPTER 2: LITERATURE REVIEW4

Dementia4

Causes of Dementia6

Symptoms of Dementia7

Diagnosis of Dementia7

Definition of Pain8

Determining the Presence of Pain in Severe Dementia8

Historical Perspective of Pain Assessment in Patients with Dementia10

CHAPTER 3: METHODOLOGY12

Research Design12

Ethical Considerations13

REFERENCES14

CHAPTER 1: INTRODUCTION

The purpose of this chapter is to provide the reader a brief overview about the research topic and provides the main purpose and aim behind this research study. It comprises of the background of the problem, which provides a brief overview of the topic of the research and the problem.

Research Background

The patient with late-stage Alzheimer's dementia lacks the ability to express pain which leads to under-treatment of the pain and needless suffering. Research has shown that people with late stages of the disease still react to various stimuli and experience uncomfortable sensations (Levy, 2008, 18). The ability to detect pain through accurate assessment is hindered in the cognitively impaired older adult by the subjective nature of pain, lack of appropriate assessment tools, nurses' lack of knowledge, and misunderstandings about pain perceptions and aging (Levy, 2008, 19).

The difficulty related to detecting pain is further compounded by other factors that may be present. These factors many include (a) the use of chemical or physical restraints, (b) altered state of consciousness, (c) sensory impairments, (d) depression, (e) memory loss, and (f) loss of intellectual functioning (Levy, 2008, 19). Therefore, it is important to develop a nursing protocol that focuses on the use of assessment tools that are sensitive to the cognitive impairments of the patient with late-stage Alzheimer's dementia.

Aims and Objectives

The main purpose of this research study was to present the best accessible evidence on the pain assessment in patients who have been diagnosed with dementia. The research objectives are stated below:

To understand the concept of dementia and pain in dementia.

To explore various practices regarding the management of pain that incorporate assessment and treatment.

To assess the best practice that can be used to for pain management in sever dementia.

Significance of the Study

Cognitively impaired patients lack the ability to communicate their needs and are not able to provide reliable verbal information related to the pain they are experiencing. Therefore, it is the intent of this research study to evaluate the past research related to pain assessment in late-stage of dementia patients. The information obtained can be utilized to develop a pain assessment and treatment protocol that can best meet the needs of the patients with late-stage of dementia in hospitals.

Structure of the thesis

The organisation of the dissertation is illustrated in the following diagram.

Figure 1: Flow Chart Illustrating the Structure of the Thesis

CHAPTER 2: LITERATURE REVIEW

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