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Psychosocial Approaches to Prevent and Minimize Pain in People With Dementia During Morning Care

TALERICO, KAREN AMANN PHD, RN, CNS; MILLER, LOIS L. PHD, RN; SWAFFORD, KRISTEN MS, RN, CNS; RADER, JOANNE MN, RN; SLOANE, PHILIP D. MD, MPH; HIATT, SHIRIN O. MPH, RN

FEATURE TOPIC: HEARING AND HEALING THE HURTS OF DEMENTIA, PART II
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Unrecognized and untreated pain occurs in people with dementia, in large part, because of their inability to communicate verbally. It has been suggested that they communicate pain through behavioral symptoms such as aggression, resisting care, and distressed vocalizations. In this second of 2 articles, clinical results are presented from a pilot study of an intervention to prevent and reduce pain during morning care in nursing home residents with moderate and advanced dementia. Qualitative clinical findings from the psychosocial component of an intervention called CARE (Comfort And Responsiveness Enhancement) are summarized. Clinically relevant strategies for responding to and preventing pain and discomfort in people with dementia during morning care include recognizing pain caused by caregiving, communication approaches in response to pain expressions, and specific caregiving techniques for dressing, shaving, grooming, washing, moving, and turning.

Karen Amann Talerico, PhD, RN, CNS, is a consultant for Amann Talerico Consultants, Portland, Oregon.

Lois L. Miller, PhD, RN, is a professor at Oregon Health & Science University, School of Nursing, Portland.

Kristen Swafford, MS, RN, CNS, is a doctoral student at Oregon Health & Science University, Portland.

Joanne Rader, MN, RN, is a consultant for Rader Consulting, Silverton, Oregon.

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.

Shirin O. Hiatt, MPH, RN, is a senior research associate at Oregon Health & Science University, Portland.

Address correspondence to: Lois L. Miller, PhD, RN, School of Nursing, Oregon Health & Science University, SN-6S, 3455 SW US Veterans Hospital Rd, Portland, OR 97239. E-mail: millerlo@ohsu.edu.

©2006Lippincott Williams & Wilkins, Inc.