title: Pain and distress in advanced dementia: choosing the right tools for the job.
abstract: OBJECTIVE
  There is a concern that pain is under-recognized in dementia. However, there may be other causes of distress. We wished to evaluate the utility of a distress tool and a pain tool.
  
  
  METHODS
  Nursing home residents with advanced dementia were observed using pain (Pain Assessment in Advanced Dementia scale (PAINAD)) and distress (Disability Distress Assessment Tool (DisDAT)) assessment tools. Those in pain were treated. Reassessment occurred at one and three months.
  
  
  RESULTS
  From 79 participants, 13 were assessed as being in pain. Psychosocial factors explained the behaviour of a false positive group. Both tools showed a significant decrease in pain following intervention (p = 0.008). Behaviours were similar in both groups.
  
  
  CONCLUSIONS
  Both tools are useful. However, the pain tool also picks up distress, which is not caused by pain. It could potentially lead to false ascriptions of pain. The distress tool picks up a broader array of signs, which may be useful both in practice and in research.
authors: Northumbria Healthcare NHS Foundation Trust, UK. ajordan@hartlepoolhospice.co.uk
authors: Alice
authors: A
authors: Jordan
authors: Claud
authors: C
authors: Regnard
authors: John T
authors: JT
authors: O'Brien
authors: Julian C
authors: JC
authors: Hughes
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000150:complications* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain / Q000175:diagnosis*; D010147:Pain Measurement / Q000379:methods*; D011594:Psychometrics; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000175:diagnosis*; D006113:United Kingdom