Pain Assessment in Dementia Patients in Hospital

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ACKNOWLEDGEMENT

I would like to take this opportunity to thank my dissertation supervisor who has always shown confidence in me. He has offered his patience, remarks, propositions and understanding. Here I would also like to mention my parents who have always believed in me for all my hard work. My family, including my parents, brother and sister has endlessly supported me during my life and academics. This has helped me in making positive decisions for my life. I would also mention my peers and co-workers and appreciate their collaboration and expert advice on every circumstance. I am also grateful towards my University and my Department, the administrators, faculty members and fellow students for their support throughout this study.

DECLARATION

I declare that the material stated in this dissertation/thesis is original and does not present work of any other scholar or research study conducted in the past. Material in this study is not partially or completely published elsewhere and collected only for the purpose of this study. I also acknowledge that I have complete understanding of the requirements, guidelines, regulations and procedures of the University with respect to the endowment of higher education degree and my research work. Here, I would also like to take the opportunity to declare that I have almost exclusively followed the requirements, guidelines, regulations and procedures of the University regarding this research study.

ABSTRACT

Identification of pain in the patient with late-stage Alzheimer's dementia is very challenging and complex. Pain is difficult to identify in the cognitively impaired patient and can manifest itself atypically. The main purpose of this research study was to present the best accessible evidence on the pain assessment in patients who have been diagnosed with dementia.

TABLE OF CONTENTS

ACKNOWLEDGEMENTII

DECLARATIONIII

ABSTRACTIV

CHAPTER 1: INTRODUCTION1

1.1Research Background1

1.2Aims and Objectives2

1.3Significance of the Study2

1.4PICO2

1.4.1Population3

1.4.2Intervention3

1.4.3Comparison3

1.4.4Outcome3

1.5Research Method4

1.5.1Research Design4

1.5.2Ethical Considerations5

CHAPTER 2: LITERATURE REVIEW7

2.1Dementia7

2.2Causes of Dementia9

2.3Symptoms of Dementia10

2.4Diagnosis of Dementia10

2.5Types of Dementia11

2.5.1Alzheimer's Type (AD)11

2.5.2Vascular Dementia12

2.5.3Lewey Body Dementia13

2.6Definition of Pain14

2.7Determining the Presence of Pain in Severe Dementia14

2.8Historical Perspective of Pain Assessment in Patients with Dementia16

2.9The Relationship between Pain and Dementia17

2.10Consequences of Pain Underassessment and Under-management20

CHAPTER 3: ALTERNATIVE TREATMENT FOR PAIN IN DEMENTIA22

3.1Basis for Implementation of Serial Trial Intervention22

CHAPTER 4: DISCUSSION AND IMPLICATIONS FOR PRACTICE25

4.1Depressive behaviour in patients of Dementia25

4.2Agitated Behaviour of People suffering from Dementia27

4.3Loss of Memory28

4.4Determining the Presence of Pain in Severe Dementia30

4.5Current Theories Explaining Decreased Pain in Persons with Dementia32

CHAPTER 5: CONCLUSION AND RECOMMENDATIONS33

5.1Conclusion33

5.2Recommendation35

REFERENCES36

CHAPTER 1: INTRODUCTION

The purpose of this chapter is to provide the reader a brief overview about the research topic and provides the main purpose and aim behind this research study. It comprises of the background of the problem, which provides a brief overview of the topic of the research and the problem.

Research Background

The patient with late-stage Alzheimer's dementia lacks the ability to express pain which leads to under-treatment of the pain and needless suffering. Research has shown that people with late stages of the disease still react to various stimuli and experience uncomfortable sensations (Levy, 2008, 18). The ability to detect pain through accurate assessment is hindered ...