Pain and Dementia
CON Researcher Receives $1.1 Million to Study Pain and Assessment for People with Dementia
An untold number of people live in pain, yet are unable to communicate this to their caretakers. They are people with dementia.
The National Institute of Nursing Research awarded a major grant to Christine Kovach, associate professor, College of Nursing, to study ways to improve the diagnosis and treatment of pain in people with dementia.
Kovach received $364,000 to fund the first year of the research. The planned total award for the three-year grant is $1.1 million. The research grant will allow Kovach and her fellow researchers to scientifically test a five-step process designed to help dementia patients who can express their physical or emotional pain only through agitation, verbal outbursts or physical aggression. "If health care professionals can recognize the pain underlying specific behaviors, they can best treat the pain," Kovach says.
"Often, patients suffering from mid- to final stages of dementia receive no pain relief or inappropriate pain relief because they can't clearly express their needs," says Kovach, who has done extensive research and writing on gerontological nursing and treatment of dementia patients. "Research results clearly indicate that they often under-treated for pain and are at risk of being inappropriately treated with strong anti-psychotic medications for their behavior. We want to help people who are on life's final journey by improving their comfort, quality of life of and human dignity."
The tool she and her fellow researchers from the University of Wisconsin-Madison and the Medical College of Wisconsin are testing is called the Assessment of Discomfort in Dementia (ADD) protocol. The ADD protocol is a five-step process that helps nurses and others who care for dementia patients more accurately determine if physical or psychological pain is causing a patient's disruptive behavior, and then treat the pain appropriately.
In previous pilot testing of the ADD protocol, the behavior of 83 percent of the patients involved improved. In some cases, says Kovach, giving patients simple pain relievers like acetaminophen helped. (Generally, she says, aspirin, ibuprofen and other NSAIDs -- non-steroidal anti-inflammatory drugs -aren't recommended for elderly patients because of potential bleeding problems.)
Kovach and her fellow researchers plan to scientifically test the results of their pilot research with a double-blind study of 100 elderly people suffering from dementia. Caregivers will use the ADD protocol with half of those in the study; the other half will receive standard care.
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