Pain management
There is strong evidence of under-recognition of pain in people with dementia. An accurate diagnosis of pain is notoriously difficult for a population where individuals cannot tell you when, where, why or how much they are hurting.
A change in the person’s behaviour, which may indicate pain, is often noticed by family and friends. The intimate knowledge of the person with dementia that families and carers can provide is a valuable resource in assisting GP's and service providers in the difficult task of distinguishing between physical pain and other causes for distress.
Any change in the person’s usual behaviour may possibly denote pain and should be investigated.[1]
Pain in severe dementia should be treated both pharmacologically and non-pharmacologically. A person-centred approach that considers the person's history and preferences should be adopted when choosing non-pharmacological therapies.
Pain indicators
Some of the main observable indicators of pain are:
- facial expression (e.g. grimacing) or body language (e.g. restlessness, agitation, guarding a part of the body, rocking, muscle tenseness);
- change in vital signs such as increase in pulse rate, breathing rate, blood pressure and sweating;
- repetitive noises or inconsolable moaning.
Pain Assessment Tools
1. Dementia Australia Paper: Palliative Care and Dementia, J.Abbey 2006 pg. 9
Clinical Practice Guidelines for Dementia in Australia: Recommendations 2016