Pain assessment is regarded as one of the most important vital sign to be assessed, but sadly, it is often underestimated by health workers and relatives. Since it is subjective, it would be difficult to determine if a patient is in pain unless the nurse would make an extra effort to assess or if the patient would verbalize that he/she is in pain. For patients with cognitive impairment where there is a barrier in communication, identifying pain could impose a big problem.
In a five-year study conducted with the participation of six nursing homes, nurses and relatives caring for the patient were tasked to assess the intensity of pain using the pain scale of 0-10. Participants included 174 elderly patients, 124 experiencing dementia while 50 did not.
The results of these study show that relatives and caregivers often are unaware that the patient is in pain. Using the 1-10 pain scale is not enough in the assessment of pain. As said in the article “it has to be a multidimensional approach”.
Part of the reason why pain is under assessed could be because nurses have too much on their hands that they do not have the time to sit down and approach their patient to get a comprehensive pain assessment. Talking to the patient or simply asking them how they are feeling is important especially for those who don’t want to be a bother and opt to keep the pain to themselves. Telling the patient that its okay for them to verbalize feelings of pain would encourage them to report it, which not only helps the nurse assess or trend the pain but also allow caregivers to provide comfort measures for the felt pain.
Other than relying on pain medications, nurses and caregivers are also encouraged to utilize other measures of pain management like massage therapy, imagery, and providing distractions from pain such as engaging in conversation and music.
For further understanding on pain assessment and dementia, listen to these previous episodes of the Nursing Show
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