title: Underrecognition and Undertreatment of Pain and Behavioral Symptoms in End-Stage Dementia.
abstract: End-stage dementia, a terminal condition, is associated with a high prevalence of physical pain and behavioral symptoms. As these patients often have a decreased ability to express their symptoms, they are often underrecognized and undertreated. This article proposes opportunities to improve patient care. The article underscores the role of assessment scales to optimize behavioral management for patients with dementia and discusses the value of pain management to improve behavioral symptoms. Additionally, a collaborative interdisciplinary team, including palliative medicine, pharmacy services, and spiritual support can optimize patient care and develop a plan of care.
authors.affiliation: Adult Palliative Medicine Service, MultiCare Health System, Tacoma General Hospital, Tacoma, WA, USA david.brecher@multicare.org.
authors.forename: David B
authors.initials: DB
authors.lastname: Brecher
authors.affiliation: Department of Pharmacy, Pharmacy Specialist, Tacoma General Hospital, Tacoma, Washington, WA, USA.
authors.forename: Tasheba L
authors.initials: TL
authors.lastname: West
mesh_terms: D001526:Behavioral Symptoms / Q000209:etiology* / Q000628:therapy*; D003704:Dementia / Q000150:complications*; D006801:Humans; D010146:Pain / Q000209:etiology*; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D010166:Palliative Care / Q000458:organization & administration; D010347:Patient Care Planning / Q000458:organization & administration; D010348:Patient Care Team / Q000458:organization & administration; D010593:Pharmaceutical Services / Q000458:organization & administration; D026443:Spiritual Therapies / Q000458:organization & administration; D013727:Terminal Care / Q000458:organization & administration
keywords: assessment scales; behavioral symptoms; end-stage dementia; interdisciplinary team; pain management; palliative care