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Review
. 2021 Oct 19;6(4):101.
doi: 10.3390/geriatrics6040101.

Pain Assessment for Individuals with Advanced Dementia in Care Homes: A Systematic Review

Nansi Felton  1 , Jennifer S Lewis  2   3 , Sarah-Jane Cockburn  1   4 , Margot Hodgson  1 , Shoba Dawson  5
Affiliations
Review

Pain Assessment for Individuals with Advanced Dementia in Care Homes: A Systematic Review

Nansi Felton et al. Geriatrics (Basel). .

Abstract

Pain is prevalent in older people, especially in those with advanced dementia who have communication impairments. Although pain is recognised to be present in this population, it is often under-assessed and ineffectively managed. The assessment of pain in advanced dementia is extremely challenging and complex, particularly in institutional settings such as care homes. This study systematically reviews the literature to examine and characterise the evidence for the use of pain assessment tools in care homes with individuals living with advanced dementia. Relevant publications were sourced from electronic bibliometric medical databases including AMED, CINAHL Plus, Medline, PsycINFO, EMBASE, TRIP Pro, Google Scholar, and HINARI. The database search was supplemented by screening citations and reference lists, in addition to a grey literature searches. The search identified 2221 studies, among which 26 were included in the review. The majority of the studies were observational, which created a rich source of data to create four major themes. The findings were informed and shaped by working with key stakeholders to develop a conceptual model that can contribute to developing evidence-based practice. This highlights the importance of a comprehensive, multi-disciplinary approach to pain assessment in this population, which is beyond the use of tools.

Keywords: advanced dementia; care homes; pain assessment; systematic review.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Search strategy using the PRISMA flowchart.
Figure 2
Figure 2
Conceptual Model. Integration of standardised and person-centred models of pain management for individuals living with advanced dementia in care homes.
Figure 3
Figure 3
Pain Decision-making Model. Advanced dementia in the care home setting.
See this image and copyright information in PMC

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