Pain assessment scales in mentally impaired patients: a review

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Dementia is a chronic and degenerative condition, rapidly growing among the population, and mainly strikes older patients (the incidence rates range from 1% to 5% in patients aged over 65). Nothwithstanding the deep changes caused by dementia in the central nervous system, it is known in literature that patients may still perceive pain. Persons with dementia may not be able to express their pain verbally; this can lead to underestimation and undertreatment. One of the main barriers to correct pain assessment lays in insufficient education and the lack of adequate tools. Several observational scales, based upon the patients’ behavior, have been developed, each with its own points of strength and drawbacks. Literature recommends the NOPPAIN, PAINAD and PACSLAC scales for pain assessment in dement patients. However, further research is needed to provide additional data in the broadest possible set of clinical conditions.
Keywords: dementia, nurse, pain, pain assessment scales.

Also available in : Italiano