Abstract

RICA ESCUIN, Marisa de la  and  GONZALEZ VACA, Julia. Assessment of pain in patients with severe dementia in nursing home. Gerokomos [online]. 2014, vol.25, n.1, pp.3-8. ISSN 1134-928X.  https://dx.doi.org/10.4321/S1134-928X2014000100002.

Introduction: Pain is a geriatric syndrome which alters the quality of life of the people and their environment. In addition, patients with advanced dementia are people with short life expectancy. A proper assessment of such a subjective symptom requires information by regular caregivers. Palliative care should be extended to non-oncological diseases: the National Hospice Organization (NHO) establishes criteria for patients with advanced dementia. Method: A cross-sectional descriptive study. Area and population: 20 patients with advanced dementia criteria institutionalized in the nursing home "Núñez de Balboa" in Albacete. It was developed from March 1 to May 15, 2012. Inclusion criteria: Signature of informed consent by the legal representative, guardian, relative or carer. Sociodemographic variables: age, sex, length of hospitalization and family relationship. Clinical-care variables: diseases, advanced dementia criteria, registration of pain, analgesic treatment, pain assessment by PAINAD scale, depression assessment by Cornell scale, behavioral assessment by the NPI-NH and terminality criteria according to NHO. Statistical analysis SPSS 15. Conclusions: The pain is a cause of multifactorial functional worsening. Identifying it requires a multidisciplinary evaluation. It is related to depression and behavioral and psychological symptoms, is common in nursing homes, and it is under-diagnosed and under-treated. Residents with cognitive decline and multiple diseases are an increasing population, the nursing homes can become hospice. Medical personnel require pain screening tools for users with advanced dementia; observational scales are good instruments to assess it.

Keywords : Pain; advanced dementia; terminality; geriatrics; institutionalization; palliative care.

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