Experience assessment and management of pain in people with dementia

Pain is an inherently subjective experience that is difficult to prove. In a cognitively impaired older person whose verbal fluency is declining, both the experience and expression of pain are altered. Assessment poses many difficulties. Consequently the older person with dementia and pain may be under-treated and poorly managed. This review addresses each of these issues and makes recommendations for more effective care in the future. The search strategy for this review was carried out using Medline (1990-2002), Embase (1989-2001) and ClinPSYCH (1990-2001) databases. References cited within these sources were also reviewed. Searches were limited to English language studies. The quality of relevant studies retrieved was assessed and information from relevant papers synthesised using narrative summary.