title: The problem of pain management among persons with dementia, personhood, and the ontology of relationships.
abstract: While pain is common among seniors, it is not adequately treated or managed. In particular, pain in seniors with dementia is often undertreated and undermanaged. Although the undertreatment of pain among persons with cognitive impairments represents a serious ethical concern for pain clinicians, most writers in the area explain the undertreatment of pain by focusing on issues related to liability, fears of addiction to opioids, and erroneous beliefs that pain is a normal part of the ageing process. We argue that the philosophical notion of personhood must also be given careful attention when considering the problem of pain undermanagement. In this paper, we consider the undertreatment of pain among seniors with dementia, while focusing on the ontology of relationships and on existential philosophy. Moreover, we outline a series of recommendations to help minimize the probability of pain undertreatment in this population and to encourage considerations relating to personhood when treating people with dementia.
authors.affiliation: Faculty of Kinesiology and Health Studies, University of Regina, Saskatchewan, Canada.
authors.forename: David C
authors.initials: DC
authors.lastname: Malloy
authors.forename: Thomas
authors.initials: T
authors.lastname: Hadjistavropoulos
mesh_terms: D000368:Aged; D003704:Dementia; D004992:Ethics, Medical; D005086:Existentialism; D006801:Humans; D059408:Pain Management; D028723:Personhood; D010687:Philosophy, Nursing; D011787:Quality of Health Care; D017211:Treatment Failure