FEATURE TOPIC: TREATING BEHAVIORAL SYMPTOMSDevelopment of an Intervention to Reduce Pain in Older Adults With Dementia Challenges and Lessons LearnedMILLER, LOIS L. PHD, RN; TALERICO, KAREN AMANN PHD, RN, CNS-BC; RADER, JOANNE MN, RN, FAAN; SWAFFORD, KRISTEN BS, RN; HIATT, SHIRIN O. MPH, RN; MILLAR, SUZANNE B. PHARMD; SMITH, KEVIN R. MD; SLOANE, PHILIP D. MD, MPH Author Information Lois L. Miller, PhD, RN, is associate professor at Oregon Health & Science University, Portland. Karen Amann Talerico, PhD, RN, CNS-BC, is assistant professor at Oregon Health & Science University, Portland. Joanne Rader, MN, RN, FAAN, is associate professor at Oregon Health & Science University, Portland. Kristen Swafford, BSN, is a doctoral student at Oregon Health & Science University, Portland. Shirin O. Hiatt, MPH, RN, is a senior research associate at Oregon Health & Science University, Portland. Suzanne B. Millar, PharmD, is a clinical pharmacy coordinator and residency program director at the Portland Veterans Administration Medical Center, Portland. Kevin R. Smith, MD, is a geropsychiatrist and assistant professor at Oregon Health & Sciences University, Portland. Philip D. Sloane, MD, MPH, is the Elizabeth and Oscar Goodwin distinguished professor and associate chair, Department of Family Medicine, University of North Carolina, Chapel Hill. Address correspondence to: Lois L. Miller, PhD, RN, Oregon Health & Science University School of Nursing, SN-65, 3455 SW US Veteran's Hospital Rd, Portland, OR 97239. E-mail: [email protected]. Alzheimer's Care Quarterly 6(2):p 154-167, April 2005. Buy Abstract Despite the high prevalence of pain in older persons with dementia, pain remains highly underdiagnosed and undertreated. A major factor in unrecognized pain in persons with dementia is their inability to communicate verbally. Behavioral symptoms and other expressions of pain are common means of communicating pain in persons with dementia. Clinical results of a National Institutes of Health—funded pilot intervention study to prevent and reduce pain in nursing home residents with moderate and advanced dementia during morning care are presented. This article summarizes the challenges associated with both pain assessment and pain treatment as well as lessons learned during the analgesic medication component of this study. ©2005Lippincott Williams & Wilkins, Inc.