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Many Elderly with Dementia Can Assess Their Own Pain

Study suggests that clinicians should rely on self-assessments instead of observation

FRIDAY, July 14 (HealthDay News) -- When assessing patients with severe dementia, clinicians should not rely on observational pain scales because many patients can reliably assess their own pain levels, according to a study published in the July issue of the Journal of the American Geriatrics Society.

Sophie Pautex, M.D., of Geneva University Hospitals in Switzerland, and colleagues randomly administered three self-assessment tools -- verbal, horizontal visual, and faces pain scales -- to 129 severely demented hospitalized elderly patients. A nursing team independently completed an observational pain rating scale.

The researchers found that 61 percent of patients demonstrated comprehension of at least one of the three scales, showing the highest comprehension on the verbal and faces pain scales. They found that correlation between the three self-assessment scales was moderate to strong. They also found that the observational rating correlated at least moderately with self-assessment, but that it underestimated severity compared with all three self-assessment scales in patients reporting pain.

"These results cannot automatically be generalized to all observational scales and all care settings, although they indicate that the routine use of observational scales in severe dementia, a common practice in many clinical settings, is not justified," the authors conclude. "Self-assessment, the highest standard of pain measurement, can be reliably performed in a large proportion of severely demented older people."

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