Assessment and Management of Pain in Patients with Dementia

Painful conditions such as arthritis are as common in the elderly as in those with dementia. With the increasing severity of dementia, pain assessment gets increasingly challenging. Lack of insight may also mean that patients with dementia fail to report pain when consulting a physician. Further, language disorders and changes in communicative patterns in patients may also be a barrier. Neurodegenerative and other pathological processes may alter the central processing of pain, possibly leading to an altered processing of painful input in patients with dementia. Patients with dementia may react with behavioral changes when experiencing pain. Assessment of pain in patients with dementia can be challenging due to several factors. This chapter presents a background on pain in dementia. Furthermore, guidance on pain assessment and treatment of pain will be included. Cases will illustrate the different approaches and pitfalls.