Volume 44 Number 2 2007
Pages 295 — 304

Abstract - Moving to new settings: Pilot study of families' perceptions of professional caregivers' pain management in persons with dementia

Martha D. Buffum, DNSc, APRN, BC, CS;1-2* Mimi Haberfelde, MS, RN, AOCN1

1Department of Veterans Affairs Medical Center, San Francisco, CA; 2School of Nursing, University of California, San Francisco, CA

Abstract — Persons with advanced dementia often have pain that is underrecognized and undertreated primarily because they cannot clearly communicate their needs. Consequently, they receive fewer analgesics than cognitively intact persons with the same conditions. Several assessment methods have been developed in the past decade, yet pain assessment and management problems persist in all care settings. These problems are likely to persist when patients move between levels of care. In this study, we determined from family caregivers whether pain was problematic when their family members with dementia moved to different care settings (e.g., admission or transfer). A total of 34 family caregivers responded to an anonymous survey; 50% reported that pain was not discussed at admission or after entry into a new care setting, and 67% were not confident that staff could detect pain. Respondents' recommendations for improving pain management included regular observation and assessment, timely and consistent pain medication administration, communication with family caregivers, and staff education.

Key words: Alzheimer's disease, analgesia, caregivers, dementia, nursing homes, outcome and process assessment (healthcare), pain, pain measurement, patient admission, rehabilitation.

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