Abstract
The presentation and management of pain in older adults with dementia are highly complicated. This article addresses assessment challenges and nonpharmacological and pharmacological management strategies related to pain in those with dementia. Vigilant monitoring of comfort level and the effective use of multidimensional pain management strategies could substantially increase quality of life for older adults with dementia.
- American Geriatrics Society Panel on Pharmacological Management of Persistent Pain in Older Persons. (2009). Pharmacological management of persistent pain in older persons. Journal of the American Geriatrics Society, 57, 1331–1346.
10.1111/j.1532-5415.2009.02376.x > Crossref MedlineGoogle Scholar - Bonnewyn A., Katona C., Bruffaerts R., Haro J.M., de Graaf R., Alonso J., Demyttenaere K. (2009). Pain and depression in older people: Comorbidity and patterns of help seeking. Journal of Affective Disorders, 117, 193–196.
10.1016/j.jad.2009.01.012 > Crossref MedlineGoogle Scholar - Bruckenthal P. (2010). Integrating nonpharmacologic and alternative strategies into a comprehensive management approach for older adults with pain. Pain Management Nursing, 11(2 Suppl.), S23–S31.
10.1016/j.pmn.2010.03.004 > Crossref MedlineGoogle Scholar - Buffum M.D., Hutt E., Chang V.T., Craine M.H., Snow A.L. (2007). Cognitive impairment and pain management: Review of issues and challenges. Journal of Rehabilitation Research and Development, 44, 315–330.
10.1682/JRRD.2006.06.0064 > Crossref MedlineGoogle Scholar - Cervo F.A., Raggi R.P., Bright-Long L.E., Wright W.K., Rows G., Torres A.E., Komaroff E. (2007). Use of the Certified nursing assistant Pain Assessment Tool (CPAT) in nursing home residents with dementia. American Journal of Alzheimer’s Disease and Other Dementias, 22, 112–119.
10.1177/1533317506298907 > Crossref MedlineGoogle Scholar - Cohen-Mansfield J. (2006). Pain Assessment in Noncommunicative Elderly persons—PAINE. The Clinical Journal of Pain, 22, 569–575.
10.1097/01.ajp.0000210899.83096.0b > Crossref MedlineGoogle Scholar - Dusek J.A., Otu H.H., Wohlhueter A.L., Bhasin M., Zerbini L.F., Joseph M.G., Libermann T.A. (2008). Genomic counter-stress changes induced by the relaxation response. PloS One, 3(7), e2576.
10.1371/journal.pone.0002576 . Retrieved from http://www.plosone.org/article/info:doi:/10.1371/journal.pone.0002576 > CrossrefGoogle Scholar - Feldt K.S., Ryden M.B., Miles S. (1998). Treatment of pain in cognitively impaired compared with cognitively intact older patients with hip-fracture. Journal of the American Geriatrics Society, 46, 1079–1085. > Crossref MedlineGoogle Scholar
- Fine P.G., Herr K.A. (2009). Pharmacologic management of persistent pain in older persons. Clinical Geriatrics, 17(4), 25–32. > Google Scholar
- Fuchs-Lacelle S., Hadjistavropoulos T. (2004). Development and preliminary validation of the Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC). Pain Management Nursing, 5, 37–49.
10.1016/j.pmn.2003.10.001 > Crossref MedlineGoogle Scholar - Hadjistavropoulos T., Herr K., Turk D., Fine P.G., Dworkin R.H., Helme R., Williams J. (2007). An interdisciplinary expert consensus statement on assessment of pain in older persons. Clinical Journal of Pain, 23(1 Suppl.), S1–S43.
10.1097/AJP.0b013e31802be869 > Crossref MedlineGoogle Scholar - Herr K. (2010). Pain in the older adult: An imperative across all health care settings. Pain Management Nursing, 11(2 Suppl.), S1–S10.
10.1016/j.pmn.2010.03.005 > Crossref MedlineGoogle Scholar - Herr K., Bursch H., Ersek M., Miller L.L., Swafford K. (2010). Use of pain-behavioral assessment tools in the nursing home: Expert consensus recommendations for practice. Journal of Gerontological Nursing, 36(3), 18–29.
10.3928/00989134-20100108-04 > LinkGoogle Scholar - Herr K., Coyne P.J., McCaffery M., Manworren R., Merkel S. (in press). Pain assessment in the patient unable to self-report: Position statement with clinical practice recommendations. Pain Management Nursing. > Google Scholar
- Hodgson N.A., Andersen S. (2008). The clinical efficacy of reflexology in nursing home residents with dementia. The Journal of Alternative and Complementary Medicine, 14, 269–275.
10.1089/acm.2007.0577 > Crossref MedlineGoogle Scholar - Hølen J.C., Hjermstad H.J., Loge J.H., Fayers P.M., Caraceni A., De Conno F., Kaasa S. (2006). Pain assessment tools: Is the content appropriate for use in palliative care?Journal of Pain and Symptom Management, 32, 567–580.
10.1016/j.jpainsymman.2006.05.025 > Crossref MedlineGoogle Scholar - Husebo B.S., Ballard C., Sandvik R., Nilsen O.B., Aarsland D. (2011). Efficacy of treating pain to reduce behavioural disturbances in residents of nursing homes with dementia: Cluster randomised clinical trial. BMJ, 343, d4065.
10.1136/bmj.d4065 > Crossref MedlineGoogle Scholar - Jan M.-H., Lin J.-J., Liau J.-J., Lin Y.-F., Lin D.-H. (2008). Investigation of clinical effects of high- and low-resistance training for patients with knee osteoarthritis: A randomized controlled trial. Physical Therapy, 88, 427–436.
10.2522/ptj.20060300 > Crossref MedlineGoogle Scholar - Jungquist C.R., O’Brien C., Matteson-Rusby S., Smith M.T., Pigeon W.R., Xia Y., Perlis M.L. (2010). The efficacy of cognitive-behavioral therapy for insomnia in patients with chronic pain. Sleep Medicine, 11, 302–309.
10.1016/j.sleep.2009.05.018 > Crossref MedlineGoogle Scholar - Kelley A.S., Siegler E.L., Reid M.C. (2008). Pitfalls and recommendations regarding the management of acute pain among hospitalized patients with dementia. Pain Medicine, 9, 581–586.
10.1111/j.1526-4637.2008.00472.x > Crossref MedlineGoogle Scholar - Kovach C.R., Logan B.R., Noonan P.E., Schlidt A.M., Smerz J., Simpson M., Wells T. (2006). Effects of the serial trial intervention on discomfort and behavior of nursing home residents with dementia. American Journal of Alzheimer’s Disease and Other Dementias, 21, 147–155.
10.1177/1533317506288949 > Crossref MedlineGoogle Scholar - Kunz M., Mykius V., Scharmann S., Schepelman K., Lautenbaucher S. (2009). Influences of dementia on multiple components of pain. European Journal of Pain, 13, 317–325.
10.1016/j.ejpain.2008.05.001 > Crossref MedlineGoogle Scholar - Kwekkeboom K.L., Abbott-Anderson K., Wanta B. (2010). Feasibility of a patient-controlled cognitive-behavioral intervention for pain, fatigue, and sleep disturbance in cancer. Oncology Nursing Forum, 37(3), E151–159.
10.1188/10.ONF.E151-E159 > Crossref MedlineGoogle Scholar - Kwekkeboom K.L., Gretarsdottir E. (2006). Systematic review of relaxation interventions for pain. Journal of Nursing Scholarship, 38, 269–277.
10.1111/j.1547-5069.2006.00113.x > Crossref MedlineGoogle Scholar - Landi F., Russo A., Liperoti R., Danese P., Maiorana E., Pahor M., Onder G. (2009). Daily pain and functional decline among old-old adults living in the community: Results from the ilSIRENTE study. Journal of Pain and Symptom Management, 38, 350–357.
10.1016/j.jpainsymman.2008.10.005 > Crossref MedlineGoogle Scholar - Lutgendorf S.K., Mullen E. (2009). Energy medicine and cancer. In (Eds.), Integrative oncology (pp. 341–376). New York: Oxford University Press. > Google Scholar
- Mahoney A.E.J., Peters L. (2008). The Mahoney Pain Scale: Examining pain and agitation in advanced dementia. American Journal of Alzheimer’s Disease and Other Dementias, 23, 250–261.
10.1177/1533317508317524 > Crossref MedlineGoogle Scholar - McDonald D.D., Shea M., Rose L., Fedo J. (2009). The effect of pain question phrasing on older adult pain information. Journal of Pain and Symptom Management, 37, 1050–1060.
10.1016/j.jpainsymman.2008.06.008 > Crossref MedlineGoogle Scholar - Park H. (2010). Effect of music on pain for home-dwelling persons with dementia. Pain Management Nursing, 11, 141–147.
10.1016/j.pmn.2009.05.004 > Crossref MedlineGoogle Scholar - 2011). Pain assessment and pharmacologic management. St. Louis: Mosby Elsevier. > (Eds.). (Google Scholar
- Pesonen A., Kauppila T., Tarkkila P., Sutela A., Niinisto L., Rosenberg P.H. (2009). Evaluation of easily applicable pain measurement tools for the assessment of pain in demented patients. Acta Anaesthesiologica Scandinavica, 53, 657–664.
10.1111/j.1399-6576.2009.01942.x > Crossref MedlineGoogle Scholar - Reuben D., Herr K., Pacala J., Pollack B., Potter J., Semla T. (2011). Geriatrics at your fingertips (13th ed.). New York: American Geriatrics Society. > Google Scholar
- Reynolds K.S., Hanson L.C., DeVellis R.F., Henderson M., Steinhauser K.E. (2008). Disparities in pain management between cognitively intact and cognitively impaired nursing home residents. Journal of Pain and Symptom Management, 35, 388–396.
10.1016/j.jpainsymman.2008.01.001 > Crossref MedlineGoogle Scholar - Scherder E., Herr K., Pickering G., Gibson S., Benedetti F., Lautenbacher S. (2009). Pain in dementia. Pain, 145, 276–278.
10.1016/j.pain.2009.04.007 > Crossref MedlineGoogle Scholar - Shega J.W., Rudy T., Keefe F.J., Perri L.C., Mengin O.T., Weiner D.K. (2008). Validity of pain behaviors in persons with mild to moderate cognitive impairment. Journal of the American Geriatrics Society, 56, 1631–1637.
10.1111/j.1532-5415.2008.01831.x > Crossref MedlineGoogle Scholar - Snow A.L., Chandler J.F., Kunik M.E., Davila J.A., Balasubramanyam V., Steele A.B., Morgan R.O. (2009). Self-reported pain in persons with dementia predicts subsequent decreased psychosocial functioning. American Journal of Geriatric Psychiatry, 17, 873–880.
10.1097/JGP.0b013e3181ad4f73 > Crossref MedlineGoogle Scholar - Snow A.L., Weber J.B., O’Malley K.J., Cody M., Beck C., Bruera E., Kunik M.E. (2004). NOPPAIN: A nursing assistant-administered pain assessment instrument for use in dementia. Dementia and Geriatric Cognitive Disorders, 17, 240–246.
10.1159/000076446 > Crossref MedlineGoogle Scholar - Vitiello M.V., Rybarczyk B., Von Korff M., Stepanski E.J. (2009). Cognitive behavioral therapy for insomnia improves sleep and decreases pain in older adults with co-morbid insomnia and osteoarthritis. Journal of Clinical Sleep Medicine, 5, 355–362. > Crossref MedlineGoogle Scholar
- Warden V., Hurley A.C., Volicer L. (2003). Development and psychometric evaluation of the Pain Assessment in Advanced Dementia (PAINAD) scale. Journal of the American Medical Directors Association, 4, 9–15.
10.1097/01.JAM.0000043422.31640.F7 > Crossref MedlineGoogle Scholar