Pain assessment for individuals with advanced dementia in care homes: A systematic review

Felton, Nansi; Lewis, Jennifer S.; Cockburn, Sarah Jane; Hodgson, Margot; Dawson, Shoba

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.

• Journal Article Type: Review
• Acceptance Date: Oct 14, 2021
• Online Publication Date: Oct 19, 2021
• Publication Date: Oct 19, 2021
• Deposit Date: Oct 26, 2021
• Publicly Available Date: Oct 26, 2021
• Journal: Geriatrics
• Electronic ISSN: 2308-3417
• Publisher: MDPI
• Peer Reviewed: Peer Reviewed
• Volume: 6
• Issue: 4
• Article Number: 101
• DOI: https://doi.org/10.3390/geriatrics6040101
• Keywords: Geriatrics and Gerontology; Gerontology; Ageing; Health(social science)
• Public URL: https://uwe-repository.worktribe.com/output/8032599