Valoración del dolor en pacientes con demencia avanzada institucionalizados

Abstract

Introduction: Pain is a geriatric syndrome which alters the quality of life of the people and their environment. In addition, patients with advanced dementia are people with short life expectancy. A proper assessment of such a subjective symptom requires information by regular caregivers. Palliative care should be extended to non-oncological diseases: the National Hospice Organization (NHO) establishes criteria for patients with advanced dementia. Method: A cross-sectional descriptive study. Area and population: 20 patients with advanced dementia criteria institutionalized in the nursing home "Núñez de Balboa" in Albacete. It was developed from March 1 to May 15, 2012. Inclusion criteria: Signature of informed consent by the legal representative, guardian, relative or carer. Sociodemographic variables: age, sex, length of hospitalization and family relationship. Clinical-care variables: diseases, advanced dementia criteria, registration of pain, analgesic treatment, pain assessment by PAINAD scale, depression assessment by Cornell scale, behavioral assessment by the NPI-NH and terminality criteria according to NHO. Statistical analysis SPSS 15. Conclusions: The pain is a cause of multifactorial functional worsening. Identifying it requires a multidisciplinary evaluation. It is related to depression and behavioral and psychological symptoms, is common in nursing homes, and it is under-diagnosed and undertreated. Residents with cognitive decline and multiple diseases are an increasing population, the nursing homes can become hospice. Medical personnel require pain screening tools for users with advanced dementia; observational scales are good instruments to assess it.