Highlights
- •Cognitive and functional impairment in persons living with dementia impact their pain expression.
- •Healthcare workers’ knowledge and collaboration impact pain management in dementia.
- •Understanding the baseline behaviors facilitates pain management in persons living with dementia.
- •Protocols including pain assessment, treatment, and multidisciplinary approaches are recommended.
Abstract
Approximately 50% of persons living with dementia experience pain, yet it is frequently
undetected and inadequately managed resulting in adverse consequences. This review
aims to synthesize evidence on the barriers and facilitators of pain management in
persons living with dementia. PubMed, CINAHL, PsycINFO, and Web of Science datasets
were used for article searching. Inclusion criteria were peer-reviewed original articles
written in English that examined the barriers and facilitators of pain management
for persons living with dementia. The Mixed Methods Appraisal Tool was used to evaluate
the quality of the studies. A total of 26 studies were selected, including 18 qualitative
and 3 quantitative (all high quality), as well as 5 mixed methods studies (low-to-high
quality). Results were categorized into intrapersonal, interpersonal, environmental,
and policy categories. Factors that impact pain management in dementia include cognitive
and functional impairment, healthcare workers’ knowledge, collaboration and communication,
healthcare workers’ understanding of patients’ baseline behaviors, observation of
behaviors, pain assessment tool use, pain management consistency, staffing level,
pain guideline/policy, and training. Overall, pain management is challenging in persons
living with dementia. The results indicate that there is a need for multi-component
interventions that involves multidisciplinary teams to improve pain management in
persons living with dementia at the intrapersonal, interpersonal, environmental, and
policy levels.
Perspectives
This review systematically synthesized barriers and facilitators of providing pain
management in persons living with dementia. Results were presented in intrapersonal,
interpersonal, environmental, and policy categories and suggests that multicomponent
interventions involving multidisciplinary teams are needed to systematically improve
pain management in persons living with dementia.
Keywords
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Article info
Publication history
Accepted:
December 24,
2022
Received in revised form:
December 7,
2022
Received:
August 11,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© Published by Elsevier Inc. on behalf of United States Association for the Study of Pain, Inc.
