Feb 22, 2018

Severe Dementia: Is There a Link Between Pain and Quality of Life?

Dementia has a wide range of symptoms that vary from person to person. In the later stages of dementia, people may be unable to remember events that took place a few minutes previously, they may lose their ability to speak and experience restlessness or anxiety.

What people may not realise is those living with dementia may actually be in a great amount of pain.

And when a person is in pain, their quality of life is undoubtedly affected.

One research looked into the connection between pain and quality of life – attempting to quantify it in people who are living with dementia.

Many variables influence the quality of life in older adults with dementia. Pain, neuropsychiatric symptoms, and depressive symptoms appear to be important factors that influence the quality of life for nursing home residents with severe dementia.

Therefore, multidimensional interventions may be beneficial for maintaining or improving quality of life in this population.

These interventions include pharmaceutical drug therapies, as well as non-pharmaceutical therapies.

Dementia is not a single specific disease, but is an umbrella term describing a syndrome associated with more than 100 different diseases that are characterised by the impairment of brain functions, including language, memory, perception, personality and cognitive skills.

However, people with dementia often have other health conditions and comorbidities, which impact their mobility, and physical health – and may even cause them pain.

People with dementia have increased risk for conditions such as;

  • Delirium
  • Depression
  • Inadequate recognition and management of pain
  • Falls (through impaired judgment, gait, visual space perception and the ability to recognise and avoid hazards)
  • Urinary and faecal incontinence
  • Dysphagia and aspiration.

Dementia is very common among people living in aged care facilities – affecting more than 50 per cent of residents living in Australian aged care.

Pain is highly prevalent in people with dementia as mentioned earlier, studies have shown that up to 80% of residents in aged care facilities who have dementia also experience chronic pain.

Among older people, pain is frequently underdiagnosed and undertreated – and this problem is more pronounced amongst residents with impaired cognition.

As residents with dementia have difficulties verbally communicating pain, the only indicators of pain may be altered behaviours such as agitation, aggression, resistance to care, calling out and verbal abuse.

Pain can be overlooked as a cause and these behaviours are often attributed to a symptom of dementia. This can result in not only the undertreatment of pain, but also its mistreatment use of psychotropics.

It is also important to recognise that uncontrolled pain can be a cause of hyperactive or hypoactive delirium.

People with dementia are still able to feel pain, even if they cannot verbally convey it. And with pain being severely undertreated, it can result in older people having a low quality of life.

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