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Approaches to caring for someone with dementia
Different approaches to caring for people with dementia
Different approaches to caring for people with dementia
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Nurse practitioner should be able to recognize these descriptors and take them as potential indicators of pain and clarify with further questioning. According to Horgas & Miller (2008), older adults with cognitive or physical limitations, have difficulty expressing details about their pain. These include pain location, duration, onset, type, precipitating factors, and relieving factors of pain. Pain is a subjective experience without valid and reliable objective tests to measure it. The existence and intensity of pain are measured by patient self-report. Unfortunately, older populations with cognitive disability may have difficulty expressing pain via verbal or body language. In some cases, it is astounding to know that pain in older population with dementia is very often undertreated. Therefore, variation in patient's ability to communicate verbally can add another layer to effectively manage pain. When pain issue is not resolved, it decreases overall ability to perform daily activities, and it causes serious impacts in most life (Horgas & Miller, 2008). Likewise, older population with cognitive impairment is even more limited to communicate pain symptoms. Therefore, extra care should be provided to observe even the slightest reactions- body movement, changes in activity routines, changes in interpersonal interactions, facial expression, mental status changes, verbalizations, and vocalizations (Bruckenthal, Reid & Reisner, 2009). Additionally, certain patients may have limited movement that makes difficult for practitioners to assess them. When pain is not controlled in patients with cognitive limitation, they express their pain by being violent, angry, or refusing their routine care. There are patients who come more quiet and... ... middle of paper ... ...al management of persistent pain in older persons. (2009). Journal of the American Geriatrics Society, 57(8), 1331-1346. Reid, M., Bennett, D., Chen, W., Eldadah, B., Farrar, J., Ferrell, B., & ... Zacharoff, K. (2011). Improving the pharmacologic management of pain in older adults: identifying the research gaps and methods to address them. Pain Medicine, 12(9), 1336-1357. Somes, J., & Donatelli, N. (2013). Pain assessment in the cognitively impaired or demented older adult. Journal of Emergency Nursing, 39(2), 164-167. Wickremaratchi, M., & Llewelyn, J. (2006). Effects of ageing on touch. Postgraduate Medical Journal, 82(967), 301-304. Zwakhalen, S. G., Jenny T., S., & Najim, M. D. (2012). Which score most Likely represents pain on the observational PAINAD pain scale for patients with dementia?. Journal of the American Medical Directors Association, 13(4), 384
Tackett, J. L., Lahey, B. B., van Hulle, C., Waldman, I., Krueger, R. F., & Rathouz, P. J. (2013).
A. Chronic pain signifies a developing public health issue of huge magnitudes, mainly in view of aging populations in developed countries (Russo).
Monsivais, D. B., & Engerbretson, J. C. (2011). Cultural cues: Review of patient- centered care in patient with nonmalignant chronic pain. [Magazine ]. Rehabilitation Nursing, 36(4), 166-71. Retrieved from http://search.proquest.com.library.capella.edu/docview/876578026?accountid=27965
Dementia is common among a large population of elderly people. The disease affects not only the individual diagnosed, but also the caregivers that work towards making their life comfortable in the end. Understanding and learning about the disease is crucial in helping those that experience or live with someone who has dementia. The services and support that are currently in affect for elderly people with dementia and the caregivers is poor, and ineffective because of the lack of research and information on the topic.
Mavandadi, S., Ten Have, T. R., Katz, I. R., Durai, U. B., Krahn, D. D., Llorente, M. D., & ... Oslin, D. W. (2007). Effect of Depression Treatment on Depressive Symptoms in Older Adulthood: The Moderating Role of Pain. Journal Of The American Geriatrics Society, 55(2), 202-211. doi:10.1111/j.1532-5415.2007.01042.x
The major concepts deduced from the hypothesis fall under three categories: (1) multimodal intervention, (2) attentive care, and (3) patient participation. Multimodal intervention includes the concepts of potent pain medication, pharmacological adjuvants, and non-pharmacological adjuvants. Attentive care relates to the assessment of pain and side effects and intervention along with reassessments. Patient participation includes goal setting and patient education. The resulting outcome of these three categories working together is the balance between analgesia and side effects.
It is evident from the literature that, the adverse effects of dementia make changes in patients quality of life by changing their behavioural and functional abilities including expression of feelings or communicational skills. As a result, it becomes a challenge for the health care provider to assess or identify pain or symptoms of pain in dementia patients when they are unable to articulate their needs. Using a pain measurement tool helps the health care provider to meet this challenge, thus improve the pain management in persons with severe cognitive impairment. Throughout the research, in order to find out the suitable diagnostic tool for pain assessment in patients with advanced dementia, author reviewed studies on different pain assessment
It is difficult for a medical professional to physically see a patient 's pain unless the source is on the exterior of their bodies. According to the American College of Emergency Physicians, “Some health personnel mistakenly believe that appearance, vital signs, and the ability to sleep correlate with the presence or absence of pain. Appearance, nonetheless, is a poor predictor of pain intensity, particularly in those with chronic pain.” Doctor’s and nurses alike must put aside their bias’, predisposed beliefs, along with judgements to treat a patient experiencing pain fairly. It is a medical professional 's duty to assess and treat each patient to their fullest ability in addition to prescribing the correct medication free from bias and stereotypes. If Medical professionals have difficulty in assessing pain along with fairly prescribing medication on a case-by-case basis, then there needs to be a movement in the medical world for better teaching on this
Leggett, A., Zarit, S., Taylor, A., & Galvin, J. (2010). Stress and burden among caregivers of patients with lewy body dementia. The Gerontologist, 51(1), 76-85.
There are different types of pain which may be suffered by an individual with cancer, with some patients suffering only one type of pain, but others experiencing a range of all three types. Identifying the type of pain suffered is the first major step in ensuring effective treatment, as not all respond to different treatments in the same way (De Conno & Caraceni, 1996, p.9).
As adults grow older a substantial number of people experience pain and cognitive impairment. Assessment’s of their pain become more complex as patient’s cognitive abilities decline, patient’s losing their ability to express themselves, and not understanding their pain (Chatterjee, 2012). Dementia is one the many cognitive impairments elders might go through. It is a progressive brain disease and can be classified as mild, moderate, or severe according to the level of cognitive impairment. Cognitive impairment can affect a person’s ability to describe their pain, understand the assessment questions that are asked, recall painful events, and rate their pain on a numeric scale 0-10 (Wilsons et al, 2006). Observation assessments like the Abbey
Management of pain is very important when it comes to palliative care patients, considering that 55-95% of this patient population requires analgesia for pain relief (Creedon & O’Regan, 2010, p. [ 257]). But what is considered pain management? And why does pain continue to be inadequately treated? According to the article on chronic non-cancer pain in older people: evidence for prescribing, in the past few decades significant improvements have been made to the management of pain in palliative care. However, it is universally acknowledged that pain on a global scale remains inadequately treated because of cultural, attitudinal, educational, legal, and systemic reasons (Creedon & O’Regan, 2010, p. ...
The patient will be able to identify the factors that increase the level of his discomfort.
Nurses were responsible to have knowledge and right practice on pain assessment for their patient. In medical dictionary, pain was defined as an unpleasant sensory and emotional experience that is conveyed by sensory neurons to the brain. Pain also have been defined as an unpleasant sensation that is created by a noxious stimulus mediated along the specific nerve pathways to the central nervous system (CNS), where it is interpreted (Mosby’s Dental Dictionary, 2008). Pain was an unpleasant sensory and emotional experience associated with, actual or potential tissue damage due to a complex interaction of sensory, emotional and behavioral factors that may be acute or chronic, visceral, somatic or neurogenic
Barker, V., Giles, H., Hajek, C., Ota, H., Noels, K., Lim, T-S., & Somera, L. (2008).