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. 2015 Dec 5;5(3):459-70.
doi: 10.1159/000441717. eCollection 2015 Sep-Dec.

The Quality of Pain Treatment in Community-Dwelling Persons with Dementia

Jiwen Li  1 , A Lynn Snow  2 , Nancy Wilson  3 , Melinda A Stanley  4 , Robert O Morgan  5 , Shubhada Sansgiry  4 , Mark E Kunik  4
Affiliations

The Quality of Pain Treatment in Community-Dwelling Persons with Dementia

Jiwen Li et al. Dement Geriatr Cogn Dis Extra. .

Abstract

Background/aims: Despite pervasive and debilitating pain among elders, it is underassessed and undertreated; and cognitive impairment can add challenges. We assessed the quality of pain care for community-dwelling elderly patients with dementia.

Methods: We phone interviewed 203 Veterans Affairs primary care outpatients with dementia and pain and reviewed medical records to score 15 quality indicators of pain assessment and management.

Results: Pain assessment was documented for 98%, and a standard pain scale was used for 94%. Modified pain scales were rarely used. Though 70% self-reported pain of 'quite bad' or worse, charts documented no pain in 64%. When pain was identified, treatment was offered to 80%; but only 59% had a follow-up assessment within 6 months. Nonpharmacological interventions were underused.

Conclusion: Community-dwelling elders with dementia are underdiagnosed and undertreated for pain.

Keywords: Dementia; Pain management; Quality indicators, health care; Veterans.

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