Health care systems need to manage chronic pain better in people with dementia and dispel the notion that people with dementia feel less pain, states an editorial in CMAJ (Canadian Medical Association Journal).
"Any notion that people with dementia feel pain less should be dismissed," writes Dr. Ken Flegel, Senior Editor, CMAJ. "Chronic pain is at least as prevalent among people with dementia (up to half) as it is among other elderly people."
Chronic pain among people with dementia is often undetected and therefore poorly managed. In the next few decades, it is estimated 25% of Canada's population will consist of seniors, more than 1 million of whom will have dementia. These changing demographics make it particularly important that pain management is better understood and managed in this cohort.
Flegel suggests empowering nurses who regularly care for people with dementia and know their routines and personalities. Nurses should be well-trained and supported in pain management and have flexibility to alter dosage and frequency of pain treatments for their patients' individual needs.
" ... Meeting the need for pain relief in people with dementia will require more skilled care at the bedside," writes Flegel. "What is needed most, however, is a person-centred and attentive approach. A person with dementia may be losing cognitive ability, but some aspects of personhood must still be respected - namely dignity, life-story and family connection. To this list we should add perception of pain and suffering."
"A person with dementia is not a nonperson and should not be cared for as though this were the case. To the extent that we as caregivers treat a person with dementia as a nonperson, the therapeutic relationship and the personhood of the caregiver are also diminished," Flegel concludes.