Dementia patients could be experiencing pain they cannot communicate

A study conducted by researchers at UCL has found that patients with dementia who are in hospital and in pain are more likely to experience delirium and are often unable to communicate that they are in pain.

Patient in pain with dementiaImage Credit: Ocskay Bence / Shutterstock

As reported in the journal Age and Ageing, the study found that many individuals with dementia in hospital are in pain and that more than a third of those who also have delirium cannot express how they are feeling.

It’s deeply troubling to think that this vulnerable group of patients are suffering in silence, unable to tell healthcare professionals that they are in pain.”

Liz Sampson, Senior Author

The study, which is the first of its kind to be conducted in a hospital setting, followed 230 patients (aged over 70 years) in two acute hospitals in the UK.

Sampson and team asked the patients if they were in pain and if a patient was unable to communicate, their facial expressions and body language were assessed for indications of pain.

Delirium was measured using a standard confusion assessment method.

The team reports that 49% of the patients were feeling pain while they were at rest, and that 25% felt pain when active.

Thirty-five percent of the patients with delirium were unable to communicate their pain and of those, 33% were in pain while at rest and 56% were in pain while active.

The researchers also found that the likelihood of being delirious was more than three times greater among the patients who were in pain at rest.

The authors suggest that if hospital staff can determine which patients are experiencing delirium, this could be a sign that the person is in pain.

Regular assessments could then be carried out to help manage the pain and the delirium.

In order to support people with dementia who are unable to verbalise their pain, it is vital that regular pain and delirium assessments are conducted to identify this vulnerable group of patients, not only to manage their pain but also to minimise the potential risk of delirium and the associated adverse health outcomes.”

Alexandra Feast, First Author

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