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Pain: concept analysis
Pain management in people with dementia
What might effective pain management depend upon
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Pain is considered a highly subjective assessment that should be managed promptly and appropriately. Pain assessment and management can be quite challenging. It is extremely important for nurses to develop a good rapport with the patient initially to gain their trust that he or she will respond to the needs of their pain. It is also important that the nurse believe that the patients who report pain as well as those who deny it or can not verbal express that they are in pain. A nurse that suspects pain should explore the suspected pain such as painful procedures or disorders.
This article identifies an 87-year-old woman with dementia who was brought to the emergency due to abnormal behavior observed by the nursing home staff. Certain
Pain is neither objective nor seen or felt by anybody other than the person that is experiencing it. Pain is subjective, therefore there is no way to distinguish whether or not someone is hurting and the only and best measurement of pain is that what the patient says it is. In settings such as end of life care, patients present with many different disease processes and ultimately are there because they have an average of six months to live. Along with this stage in their lives, palliative care patients can encounter a myriad of symptoms, which can result in these patients experiencing tremendous physical and psychological suffering (Creedon & O’Regan, 2010, p. [ 257]). For patients requiring palliative care, pain is the most incapacitating of symptoms and in return unrelieved pain is the primary symptom that is feared most by these patients. So why has pain management not become the top priority when it comes to end of life care, considering this area is growing at an extraordinary rate as a result of an increasingly ageing population?
Butler, R. (2008). The Carers of People with Dementia. BMJ: British Medical Journal , 336, 1260-1261.
Nurses help patients with their physical needs with details, explain the complex steps of medical treatment, communicate with doctors to share patients’ health conditions and proper treatments, and give emotional support to patients in stressful situations. There are certain limitations that nurses have in decision makings because doctors obtain the most power in patients’ medical clinics. However, nurses are more friendly, helpful, and suffering for patients. Lastly, experienced nurses can make a better choice for the patients over young and un-experience
Pain is not always curable but effects the life of millions of people. This essay examines the Essence of Care 2010: Benchmarks for the Prevention and Management of Pain (DH, 2010). Particularly reflecting on a practical working knowledge of its implementation and its relevance to nursing practice. It is part of the wider ranging Essence of Care policy, that includes all the latest benchmarks developed since it was first launched in 2001.
Lisa Genova’s grandmother, who was 85 years old, had been showing signs of dementia for years; but she was a smart and independent woman who never complained, and she navigated around her symptoms. Her nine children and their spouses, as well as her grandchildren, passed off her mistakes to normal aging. Then they got the phone call when Lisa’s grandmot...
...tive pain management and Improvement in patients outcomes and satisfaction [Magazine]. Critical Care Nurse, 35(3), 37,35,42. Retrieved from
Assessing and managing pain is an inevitable part of nursing and the care of patients. Incomplete relief of pain remains prevalent despite years of research due to barriers such as lack of kn...
Nurses assess patients’ perineal swelling, lacerations, and monitor signs of infection. In conjunction, nurses also assess patient’s pain levels from perineal trauma and can provide pharmacologic and non-pharmacologic pain relief (Steen et al., 2007). Based on the centrality of their role, it is important that nurses have access to evidence based best practices on perineal pain management. Yet, nursing does not exist in a vacuum and there are many factors that may influence the translation of research evidence into a clinical setting. As stated by the Canadian Nursing Association, “Decision-making in nursing practice is influenced by evidence and also by individual values, client choice, theories, clinical judgment, ethics, legislation, regulation, health-care resources and practice environments” (CAN, 2010, p. 3). With this at the forefront, I will explore some of the organizational challenges to implementing Steen et al.,(2007) findings, such as, cost effectiveness, practice environment, standardization and time constraints. I will then explore the application of the evidence to my clinical example by addressing how Steen et al., (2007) evidence might have changed the care I provided to my
It is evident from the literature that, the adverse effects of dementia make changes in patients quality of life by changing their behavioural and functional abilities including expression of feelings or communicational skills. As a result, it becomes a challenge for the health care provider to assess or identify pain or symptoms of pain in dementia patients when they are unable to articulate their needs. Using a pain measurement tool helps the health care provider to meet this challenge, thus improve the pain management in persons with severe cognitive impairment. Throughout the research, in order to find out the suitable diagnostic tool for pain assessment in patients with advanced dementia, author reviewed studies on different pain assessment
The author as a healthcare assistant working in the nursing home will present a scenario of Mrs. Keller (not her real name) who is confined in the dementia u...
In the film, “The Alzheimer’s Project: The Memory loss tapes” there was an 87-year-old woman with Alzheimer disease named Bessie Knapmiller. It seems as Alzheimer runs in her family because her older sister has the same disease. Bessie sister is 93 years old and she has lost her entire memory. Bessie sister does not even remember their family members. However, Bessie stage of Alzheimer is not as bad as her sister, she still drives and still remembers people. At times, Bessie does forget others. Bessie went to take a memory test in May and few months later, when she returned she did not remember her doctor or him giving her the exam. When Bessie took her first memory test she could not remember the previous president before George Bush. She
Findings. Pain has many different meanings to many people. What is important to know as a nurse or health care provider is that pain is what the patient says it is. It is not the nurse or provider’s place to determine what the patient’s pain is but rather take an in-depth history and assessment. Using this assessment and history can therefore help treat your patient’s pain accordingly. Also pain theories have been proposed and used the implications of nursing practice in regard to pain.
Pain, which is defined in its widest sense as an emotion which is the opposite of pleasure (White, 2004, p.455), is one of the major symptoms of cancer, affecting a majority of sufferers at some point during their condition (De Conno & Caraceni, 1996, p.8). The World Health Organization (WHO, 2009, online) suggests that relief from pain may be achieved in more than 90 percent of patients; however, Fitzgibbon and Loeser (2010, p.190) stress that pain may often be undertreated, even in the UK. Foley and Abernathy (2008, p.2759) identify numerous barriers to effective pain management, among which are professional barriers such as inadequate knowledge of pain mechanisms, assessment and management strategies.
Mrs. A is a 71-year-old widow with CCF and osteoarthritis who has recently been exhibiting quite unusual behavior. Her daughter is concerned about her mother 's ability to remain independent and wishes to pursue nursing home admission arrangements. She fears the development of a dementing illness. Over the last two to three months Mrs. A has become confused, easily fatigued and very irritable. She has developed disturbing obsessive/compulsive behavior constantly complaining that her lace curtains were dirty and required frequent washing. Detailed questioning revealed that she thought they were yellow-green and possibly moldy. Her prescribed medications are:
...amount of pain) is a great teaching tool for the patient who is able to self-report (Nevius & D’Arcy, 2008). This will put the patient and nurse on the same level of understanding regarding the patient’s pain. The patient should also be aware of the added information included with the pain scale: quality, duration, and location of the pain. During patient teaching, it should be noted that obtaining a zero out of ten on the pain scale is not always attainable after a painful procedure. A realistic pain management goal can be set by the patient for his pain level each day.