Xtt Task 1 Essay

As with all older adults, clients with dementia present with chronic conditions such as arthritis and acute pain experienced in the aging and the end of life process. Moss (2002) gives evidence that most elderly clients who move into long-term care will die in an institution either a nursing home or a hospital many of whom will have dementia. She states that 91% have a strong co morbid condition likely to cause pain.

Dealing with aging dementia patients can be a challenge in and of itself. However, when healthcare providers need to include regulating pain as well, the challenge becomes even greater. Pain management with cognitively impaired patients is a constant problem within geriatric care in modern healthcare facilities (Zwakhalen et al 2006). The reduced self capacity to report pain in its true degrees then makes pain management a challenge for physicians and healthcare providers (Husebo et al. 2007). Thus, research aims to explore effective measures for observing and reporting pain management within aging dementia patients.

The patient’s previous function should always be considered so as to know how far the patient has deteriorated and thus be able to consider the decline as either normal or abnormal. Nevertheless, Nathan also mentioned this, saying that older people are not afforded the same history and investigation as younger ones, thus driving basically the same point home. Older patients are discharged quickly without even being properly treated, consequently making their ailment become worse as time passes. We cannot just assume that what a patient is going through is normal and thus unimportant, rather the authors make it clear that we should give older people the same options, care, and patience that we offer to the younger

A great deal of investment in terms of research has yielded copious information regarding the individual phenomena of sleep and pain. These two subjects have even been studied to a substantial degree in specific populations, the older adult population being one of these. However, study of the interaction between these two phenomena has only recently begun to be of great notice. This interaction, though lately established in the literature, has not been adequately studied in many populations. In particular this inadequacy is notable for the older adult population. A search of the database Academic Onefile using keywords “older adults”, “sleep” and “pain” produced no literature involving all three. The literature used in this review was found with individual searches of “sleep” and “pain”, “older adults” and “sleep”, and “older adults” and “pain”. This issue is of great importance to nurses and other clinicians due to the increasing age of the patient population seen in practice (Berman, Snyder, Kozier, & Erb, 2012), and due to the pervasive difficulties with sleep and pain faced by older adults.

Aim/ purpose of study: Conglomeration of current data on pain and pain management for patients with dementia.

The research that was applied and used to guide this article has led for a pilot study to be conducted and the implementation for higher compliancy of pain scales to be completed upon dementia patients to monitor the effectiveness and patient outcomes. From the research, this allowed for implementations to be made for higher compliancy of care upon pain rating scales to be monitoring upon both routine pain rating scales and follow up pain rating scales. Of these measures, researchers were interested to know how feasible it was to monitor pain scales upon dementia patients after collecting noticing that follow up assessments were falling short. This would be noted as a barrier to change. When researchers looked into this information only half of the follow up assessments were being completed because nurses reported a limited knowledge with correct interventions and due to patient workloads (Zwakhalen, Hof, Hamers,

In this life, there are many forms of art or art “movements” to speak of. How we interpret art is a very subjective thing. What a person sees and feels when looking at art greatly depends on their upbringing, their values, and even their mood at the time of viewing. Could something dark and lacking color be art? What about a comic strip in the newspaper or the billboard down the street? Again, interpretation and taste in art is individual. I elected to explore into the two art movements I like the least to potentially better understand them, and to potentially link them together.

Frailty develops when an older adult experiences a stressor and is unable to achieve a normal homeostasis accompanied by a decrease in several physiologic systems over a period of time. With a decrease in different physiologic systems, homeostatic reserves become depleted, resulting in a minor stressor causing a change in health status that is disproportionate to the stressor. For example,

In order to identify and prevent persistent pain in elderly population with dementia, Monacelly et al. (2013) conducted a study in a nursing home in Italy by using Doloplus-2 pain assessment tool. The participants were patients (n=23) with moderate to severe dementia and were unable to express the feeling of pain. Researchers obtained consent from the management and designated legal guardians of the patients. The purpose of the study was to observe the pain symptoms of the same group of elderly population for a period of one year and evaluate the effectiveness of the pain management by using the Doloplus-2 diagnostic pain assessment tool. As an initial part of the study, presence of pain was confirmed in participated patients by using the Doloplus-2

‘Frailty thy name is woman' emotionally refers to his mother 'Hamlet' (Act 1, Scene 2). While the term “frailty” has been around for a while, the use of it in a medical literature has only been evolving in the past 30 years. However, condition with similar meaning, was described back in 1914 in a publication “The Diseases of Old Age and their Treatment” (Nascher, 1914). In this publication Nascher describes a condition of his elderly patients as “senile disability” or “senile cachexia” manifesting in general physical weakness and mental impairments as a result of the aging process. Later, several authors use term “Failure to Thrive” while describing a multifactorial state of decline in elderly (Kimball et al., 1995; Robertson et al., 2004; Sarkisian et al., 1996). The search term “frail elderly” in PubMed.gov generated 8384 results indicating great interest by clinicians and researchers in this topic. However, despite the interest there is considerable uncertainty regarding the concept and definition of frailty (Bergman et al., 2007). Frailty is “one of those complex terms – like independence, life satisfaction, and continuity – that trouble gerontologists with multiple and slippery meanings” (Kaufman, 1994).

Although there have been many improvements in health care, pain in the elderly people with dementia is often undertreated and at times it is not addressed at all. Behavioral expressions of untreated pain in this population are common and the inappropriate prescription of psychotropic medication to mask the behavioral manifestations of pain instead of addressing the pain causing the behavioral symptoms is the norm (Achterberg et. al., 2013, p. 1479). Untreated pain in this population is also a major

The authors of the article each come with their own perepectives on pain management in the cognitively impaired older adult.

Management of chronic pain can be very difficult and it is especially important to personalize the plan of care to the client and to the type of chronic pain, rather than by its cause or its severity. One of the most often relied on ways to manage chronic pain in the elderly is through pharmaceutical methods. (Pateinakis, 2013) In the elderly differences in drug efficacy and the incidences of toxicity due to decreased albumin blood serum levels and differences in absorption, distribution, metabolism, and excretion. Because of the increased risks, elderly clients should begin taking the lowest effective dose, and then gradually increase the dosage to achieve the steady state and desired effects. To begin the treatment of chronic pain, weighing

There is a growing geriatric population of people with dementia (the subpopulation) throughout the world that are living in pain constantly. Because dementia as a condition with multifaceted symptomology manifested by advancing overall decline of cognitive ability, it causes severe and distinctive barriers to pain assessment and pain management in this subpopulation. The existence of multiple comorbidities, polypharmacy and the declining cognition in this subpopulation results in a much more complex pain symptomology. Zwakhalen, Hamers, Abu-Saad, and (replaced & with and) Berger, (2006), explain that common behaviors associated with pain may be absent or difficult to interpret in this subpopulation because some dementia symptoms may be an indication of pain, but such behavior, however, might also be incorrectly interpreted as a symptom of dementia. Therefore, pain in this subpopulation is exceptionally challenging to evaluate and manage as a result of this difficulty.

In 2002, the American Geriatrics Society established comprehensive guidelines for assessing behavioral indicators of pain.1 More recently, the American Society for Pain Management Nursing Task Force on Pain Assessment in the Nonverbal Patient (including persons with dementia) recommended a comprehensive, hierarchical approach that integrates selfreport and observations of pain behaviors.11 Recently, tools to measure pain in persons with dementia have proliferated. In 2006, a comprehensive stateof-the-science review of 14 observational pain measures was completed. The authors concluded that existing tools are still in the early stages of development and testing and that more psychometric work is needed before tools are recommended for broad adoption in clinical practice.12 Others, including an interdisciplinary expert consensus