Exploring Behaviours Related to Pain Indication for Residents in Long-Term Care with Dementia

Abstract

Aim: The aim of this article is to explore the behaviours related to pain for residents of long-term care with dementia.
 Background: Nurse practitioners caring for residents with dementia face the complex task of assessing and managing pain. Residents in long-term care who live with dementia may express pain differently than those without cognitive or communication impairments. Responsive behaviours that may occur in advancing dementia may also be indicators of pain. Tools that consider behaviours related to pain for cognitively impaired residents such as the PACSLAC, should be considered.
 Methods: This secondary analysis is a retrospective population-based descriptive study of Resident Assessment Instrument-Minimum Data Set version 2.0 assessments conducted in long-term care homes across Ontario.
 Findings: Results show that, in many circumstances when a resident with dementia exhibits responsive behaviors that may be related to both dementia and pain, no pain is reported. These items include wandering, resisting care, and repetitive verbalizations. The findings suggest that pain may not be identified or treated in people with dementia.
 Conclusions: Nurse practitioners must provide an individualized approach in order to accurately assess and treat pain for residents with dementia. By acknowledging deficits and improving practice guidelines, the hope is to improve pain management and quality of life for residents with dementia and pain.