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Pain assessment for older adult

Although common, it is under-recognized and undertreated in the elderly. This inadequate recognition and treatment lead to depression, social isolation, immobility, sleep disturbance, and decrease in quality of life for older persons. Thus, it is important for providers to recognize pain and treat it in the elderly to prevent increased morbidity. An effective pain management approach generally includes assessment and treatment steps.
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Pain Assessment in Older Adults

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Pain Assessment in the Elderly

Many cognitively impaired patients communicate poorly if at all, or are unable to describe pain or discomfort accurately. Conversely, patients who have pain often report cognitive changes, such as forgetfulness and poor concentration. Cognitive Impairment Cognitive impairment is a broad term that includes many symptoms Table and describes a wide range of conditions that develop from numerous possible causes. It may stem from physical problems, such as a neurologic disorder eg, dementia, developmental disability , musculoskeletal problems, delirium, or sleep deprivation. Cognitive impairment also may have psychological or psychiatric causes, including poor coping skills, stressful circumstances, anxiety, emotional instability, or, often, depression. Often, the cognitively impaired patient is an older adult who has dementia or the cumulative ravages of drug or alcohol abuse.
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Complexities of Pain Assessment

When assessing patients with dementia therapists must be aware that the patient may not be capable of directly communicating exactly where the pain is, or even whether they are in pain at all [10]. Horgas, A. Although assessing pain in patients with dementia can be challenging, there is evidence to suggest that patients with mild to moderate dementia can effectively self-report pain levels when appropriate assessment tools are chosen [11] [12].
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Accurate assessment of pain in people with dementia is challenging and pain assessment tools have received considerable attention over the years, with an increasing number of tools made available. Systematic reviews on the evidence of their validity and utility mostly compare different sets of tools. This review of systematic reviews analyses and summarises evidence concerning the psychometric properties and clinical utility of pain assessment tools in adults with dementia or cognitive impairment. Methods We searched for systematic reviews of pain assessment tools providing evidence of reliability, validity and clinical utility.
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