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AJN The American Journal of Nursing. 108(7):62-70, July 2008 AJN The American Journal of Nursing. 108(6):40-47, June 2008
Whether patients are cognitively intact and able to quantify their pain and communicate without difficulty, or in end-stage dementia with severely limited verbal ability, the presence and severity of pain can be determined using a variety of tools found in the Try This series. This video includes demonstrations of how to assess for pain in any older adult, and to reassess to determine the effectiveness of interventions, using four distinct tools: the Faces Pain Scale, the Verbal Descriptor Scale, the Numeric Rating Scale, and the Pain Assessment in Advanced Dementia Scale (PAINAD). In this program, interdisciplinary team members also develop a care plan to address chronic pain in a patient with severe arthritis and a history of joint replacement, and family members who have discouraged use of medication for fear addiction might result.
For you, the thought of a warm bath or shower is probably a treat anticipated to provide comfort and relaxation. How unfortunate that for those with dementia, the bathing experience may be a painful, frightening, and humiliating procedure.
With planning and a process customized to address each person’s unique needs, or a person-centered approach, older adults with dementia can be spared a negative experience. This 30-minute program is based on the April 2006 New Look at the Old AJN article by Joanne Rader MN, RN, et al, titled: The Bathing Of Older Adults with Dementia. The video outlines cutting-edge research and presents best practices in bathing from researchers and practitioners, as well as guidance from the perspective of a state regulatory agency on what actually constitutes compliance with relevant standards of care.
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