Doloplus 2 Pain Assessment

Nearly 135 million people worldwide will be impacted by dementia by 2050 (Robinson, Tang, Taylor,. 2015). Dementia is not a disease, it is an overall term that describes a wide range of symptoms associated with the decline in memory and thinking skills. Dementia is a progressive illness that results in the loss of one’s sense of self (Burns, Byrne, Ballard, Holmes, 2002). The two most common forms of dementia are Alzheimer’s disease and Vascular dementia. Dementia is progressive and people with dementia experience complications with short-term memory, keeping track of personal items, paying bills, taking care of themselves and daily tasks (Haigh, Mytton, 2016). Due to the rising number of individuals developing dementia, it is causing major challenges in the healthcare systems and society (Angermeter, Luck, Then, Riedel-Heller, 2016). Utilizing psychotropic medications are often ineffective or harmful to the individual, therefore, many patients decide to utilize sensory therapy as a form of treatment instead (Livingston, Kelly olmes, et al., 2014). Caregivers of individuals with dementia can also experience health consequences related to caregiving at the end of life. Spousal caregivers are 40.5% higher odds of experiencing frailty as a result of caregiving (Carr, Dassel, 2017). Dementia does not only affect the individual, it affects those around them, society, and the healthcare system.

pain is the usual cause for persons to look for treatment. Inadequate pain management can cause delay in healing process. It can also leads to prolonged hospital stay. The acute pain management theory describe how nurse can manage pain with minimal effects from the pharmacological interventions and use of alternative methods of pain management (Good &Moore, 1996) The main factors are in the management of pain are Pharmacological, non-pharmacological, patient participation, education and different interventions. Effective pain management involves the application of non-pharmacological interventions and usage of pain medications. (McEwen & Willis, 2014). The pain management theory deals with management of pain in daily basis. It offers the knowledge about alternate methods in pain

5. Zwakhalen, S., Hof, C., & Hamers, J. (2012). Systematic pain assessment using an observational scale in nursing home residents with dementia: exploring feasibility and applied interventions. Journal Of Clinical Nursing, 21(21/22), 3009-3017. doi:10.1111/j.1365-2702.2012.04313.x

Within the dementia care environment, it is my experience that it is often unclear to nursing staff as to appropriate assessment and management of pain for clients in the palliative stage of their illness.

Dealing with aging dementia patients can be a challenge in and of itself. However, when healthcare providers need to include regulating pain as well, the challenge becomes even greater. Pain management with cognitively impaired patients is a constant problem within geriatric care in modern healthcare facilities (Zwakhalen et al 2006). The reduced self capacity to report pain in its true degrees then makes pain management a challenge for physicians and healthcare providers (Husebo et al. 2007). Thus, research aims to explore effective measures for observing and reporting pain management within aging dementia patients.

Several patients suffered from dementia and some had accompanying diagnoses, such as hip fracture from falling or upper and lower extremity weakness. Dementia is a decline in memory and greatly affects how activities

To achieve effective and excellence care on dementia, biological, psychological and social approach to dementia has to consider because it provides an understanding to people with dementia and help improved health practice, treatment and support for better dementia care (Bowers & Downs, 2008). Biological approach tackles the disease process of dementia, the cause of brain injury and the changes in behavior pattern of dementia sufferers. On the other hand, psychological approach to dementia involved the sufferer’s reaction to the injury, how they accept it and deal the situation. It also covers the effect of the disease process on their communication and action in relation to others. Particularly, people with dementia, mostly feel embarrassed and depressed by their brain injury. They are often angry, agitated and frightened because of the disease but maybe it also means seeking help to avoid embarrassment and disgrace. Dementia care in social domain explains the right of the person with dementia to enjoy and experience significant social interaction. Friendly environment and venues with sociable care provider that makes them comfortable and feels worthy is the focus. In addition, social identities of the people with dementia should be valued and social

Nursing assessment is a substantial way of gathering physiological, psychological, spiritual, and emotional condition of the patient. It creates a whole picture of an individual and assist the health care providers to formulate a diagnosis. Assessing the comfort of the patient is equally important as taking the blood pressure or temperature. Pain is the fifth (5th) vital sign that is subjective in nature when performing an assessment of a patient. Various studies were conducted in finding the most appropriate evidence-based nursing practice in assessing and managing the pain of a cognitively impaired patient, whether it is acute or chronic or the underlying cause is cancer or post-operative incision. As emphasized by Song, Eaton, Gordon, Hoyle, and Doorenbos (2015), it is vital to ensure that “pain management is based on the best evidence” (p. 456). Perhaps knowing the causes of inability to assess and manage the pain in a cognitively impaired patient would give a clearer understanding of the practice.

Dementia is characterized as a condition where the mental processes of cognition and memory start to deteriorate. It is described as a syndrome that hinders the daily lives of those who have it and is characterized by memory and thinking impairment. The most common form of dementia is Alzheimer’s Disease and the second most common is vascular dementia. Dementia is a syndrome occurring usually, but not limited, to people over the age of 40 and is due to brain damage caused by natural deteriorating, stroke or can be brought on by factors such as excessive drinking or drug abuse. Dementia is best cared for in its early stages and, therefore, an early diagnosis is essential. Recognizing the symptoms by both the dementia patient and the

The elderly population increasing, there is more of an incidence in chronic conditions, such as cancer. Cancer is the second top cause for morbidity and mortality in the older adult population that is older than 65 years of age (nearly 71 percent of all deaths) (Erturk et al., 2015). Cancer affects both different processes of the body and psychological process. One process includes pain perception. Researchers estimate that as many as 90 percent of cancer patients experience pain and 50 percent do not receive enough pain management (as citied as Erturk el al., 2015). There is often a stigma for older adults that pain and fatigue are a common process of aging; therefore, elderly have misconceptions of medications (e.g. opioids) and attitudes about pain and will often tolerate pain (Erturk et al., 2015, p. 167). One of my previous elderly patients was admitted for abdominal pain (hepatomegaly). I chose this research article because one of my priorities for her care was to managing her pain in relation to her abdominal pain and physical activity throughout the shift. The purpose of the research article was to “evaluate the pain and fatigue levels of elderly cancer patients and to examine whether pain is an independent variable in fatigue development” (Erturk et al., 2015, p. 167).

This assignment critically discusses about dementia, a widespread disability among older adults today. It provides an introduction to dementia and analyses its prevalence in society. The various forms of dementias are elaborated with description about dysfunctions and symptoms. Nursing Assessment and Interventions are provided in the further sections which discusses about actions nurses should take on while evaluating patients and treating them. Finally, communication, an important Activity of Daily Living (ADL) is explored and patient/carer advice is presented so as to maintain good health conditions in the patient.

I my view as well as the view of the evidence-based academic literature, pain is a common and yet subjective experience for several older adults and despite its prevalence, the existing body of evidence suggests that it is poorly assessed and managed in the older patients. The cognitive impairment as a consequence of delirium and dementia represents a big challenge to the management of pain in older adults since they render these patients unable to verbalize the level of their pain. It is therefore the responsibility of us the Nurses as an integral element of a larger interdisciplinary care team to comprehend the myths that are associated with the management of pain as well as use the right tools in the assessment of the nature of pain being experienced by the older adults. In the next few paragraphs, I present my views of the four main tools of assessing pain the older adults. These include the Revised Faces

The aim of this study is to bring awareness to Alzheimer’s Disease. It is important noting that Alzheimer’s disease does not only affect the patient but also their family and caregiver. This research was conducted at St. Josephs Hospital Medical Nursing Home. We selected 10 medically diagnosed Alzheimer’s patients. We divided the patients into 2 groups. The first group consisted of patients that had a lot of moral support and affection from their families. In this group was also the grandmother of one of the contributors to this paper. The second group consisted of patients that do not receive moral support or have not seen their family for a long time.

The case study based on the palliative patient Mrs. Mavis looks at issues both the family and the patient are dealing with in regards to the end of life treatment Mrs. Mavis is receiving. Mrs. Mavis is a palliative patient, currently unconscious, who is dying and only wants comfort measures within her nursing care. This was made clear through her advanced care directive, which was made weeks before beginning to receive her end of life care. Mrs. Mavis’ comfort measures include pain relief, hygiene and keeping her comfortable. Mrs. Mavis’ family want her to have fluids and medications to help improve her health. They also want oxygen and pain relief to help with her breathing. Issues such as educating and supporting the family, pain management, the effectiveness of having an advanced care directive and pain assessment will be evaluated to determine the best effective interventions for Mrs. Mavis and her families care. Interventions that will be discussed through-out this essay include the use of analgesia medication, the use of subcutaneous injections and syringe drivers, emotional support for the family, effective communication, educating the family on Mrs. Mavis’ wishes and the importance of having an advanced care directive. These interventions will be evaluated to ensure they are the best practice for Mrs. Mavis’ care.

Dementia is a progressive process, with the symptoms and decline in function often worsening, sometimes rapidly, overtime. Although the elderly population are most frequently affected, many younger patients can also be affected. Currently, no cure, be it medical or behavioural, has been isolated, however certain treatments have proved beneficial in delaying the onset or staying off further rapid deterioration. In addition to pharmaceutical treatment modalities, other support and managerial techniques may enable n enhanced quality of life.