Sjuksköterskans smärtidentifiering hos äldre med demenssjukdom

by Rantakari, Minna-Kristiina

This study is directed primary toward nurses, but also other professions. Interest for the subject was raised during observations among demented elderly with unsolved pain problematic. Dementia diseases are reducing patients´ mental, physical and social capacity, even depressions and behaviour disturbances are common. Patients´ pain experience doesn’t change in comparison with other elderly, instead demented persons are getting difficulties to express their pain. This is challenging staffs´ ability to discover patients´ pain. Purpose of this interview study was to investigate how community nurses identify pain among advanced demented elderly and how they experience it. Result shows that communication and cooperation were central phenomena during pain judgements. Test treatments with analgesics were common because of difficulties to separate pain from other symptoms. Good communication, observations, controls, nursing experience and intuition made pain identification easier. Pain identification was getting more difficult because of advanced dementia disease, lacking communication and lack of continuity, time, knowledge and experience about missing guidelines/helping methods. Nurses had different opinions how pain identification was functioning and they suggested improvements. This study indicates a need for better coordination before symptom control among demented elderly can be considered to occur according principles of palliative care.