title: Observation of Pain in Dementia.
abstract: Recognition of pain in older persons with dementia is a considerable challenge to quality pain care for this vulnerable population. Without recognition, pain cannot be thoroughly evaluated and effectively treated. Observing for pain-related behaviors is the most researched means of identifying the presence or likelihood of pain in persons with moderate to severe dementia, or those who are unable to self-report their pain. The purpose of this paper is to discuss the state of observation of pain, primarily focusing on pain behavior tool development, providing an overview of current pain tools and discussing the challenges at this stage of the science, including the issue of assessing pain intensity. We also recommend a number of areas to prioritize future research with the goal to advance effective pain assessment in older persons with dementia. Central to these recommendations is the refinement of existing tools to incorporate those behaviors most predictive of pain in persons with dementia as the science progresses in this area. The future of pain observation in dementia is poised for considerable advancement through these refinements of tools and techniques. Improving our ability to detect and evaluate pain in the vulnerable population unable to self-report their pain, through the results of these suggested research priorities, will likely assist in addressing the related suffering that results from unrecognized and untreated pain.
authors.affiliation: College of Nursing, University of Iowa, 306 CNB, 50 Newton Road, Iowa City, IA 52333. United States.
authors.forename: Keela
authors.initials: K
authors.lastname: Herr
authors.affiliation: Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Sandra Zwakhalen, Maastricht University, Maastricht, Netherlands.
authors.forename: Sandra
authors.initials: S
authors.lastname: Zwakhalen
authors.affiliation: School of Nursing, Kristen Swafford, Oregon Health & Science University, Portland, OR. United States.
authors.forename: Kristen
authors.initials: K
authors.lastname: Swafford
mesh_terms: D000368:Aged; D003704:Dementia / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain / Q000175:diagnosis* / Q000209:etiology*; D010147:Pain Measurement / Q000379:methods*
keywords: Aging; assessment; behavior; dementia; measurement; observation; pain; tool