The assessment of discomfort in dementia protocol.
Many people with dementia are unable to clearly or consistently verbalize pain symptoms. The Assessment of Discomfort in Dementia (ADD) Protocol is a systematic tool that can be used by nurses to make a differential assessment and treatment plan for both physical pain and affective discomfort experienced by people with dementia. This ADD Protocol is based on the assumption that behaviors associated with dementia are symptoms of unmet physiologic and/or nonphysiologic needs. Steps of the process include a physical assessment, a review of the patient's history, an assessment of affective needs including environmental stress and sensoristasis, and the administration of analgesics. The ADD Protocol is unique in that it uses "as needed" analgesics as a part of the assessment process. The dualistic perspective, in which physical and affective needs are considered in tandem, is an essential and innovative feature of the ADD Protocol.
Kovach
Christine R
CR
School of Nursing, Health Restoration Department, University of Wisconsin-Milwaukee, Milwaukee, WI 53201-0413, USA. CKovach@UWM.EDU
Noonan
Patricia E
PE
Griffie
Julie
J
Muchka
Sandy
S
Weissman
David E
DE
D002985:Clinical Protocols; D003704:Dementia / Q000150:complications*; D004282:Documentation; D006801:Humans; D009729:Nursing; D010146:Pain / Q000150:complications* / Q000175:diagnosis*; D010147:Pain Measurement / Q000379:methods*; D013315:Stress, Psychological / Q000523:psychology