| Previous research on pain assessment in persons with dementia has mostly focused on nursing home or hospitalized populations, finding that this subgroup of older adults experiences comparable pain to cognitively intact elders. These studies advocate an analgesic trial to treat pain in this population as untreated chronic pain can lead to excess disabilities, such as depression and functional decline. Currently there are pain treatment guidelines specifically for older adults with dementia. Acetaminophen is the first line drug recommended in pain treatment guidelines for older adults. This feasibility study investigated the effects of acetaminophen in reducing pain behaviors and excess disabilities in community-dwelling persons with dementia. Three participants with severe dementia and their primary caregiver completed 24 daily sessions that allowed the researcher to observe for changes in pain behavior over time following an ABAB study design. During baseline phases (A), pain and excess disabilities were assessed through the completion of daily measurement tools by trained observers and informal caregivers and videotaped behavioral observations of the participant performing an activity protocol (walking, standing, sitting, and lying) designed to elicit pain. Treatment phases (B) consisted of the administration of the treatment drug, Tylenol Arthritis, 1.3 grams every 8 hours while awake in addition to Phase A procedures. Results show that acetaminophen effectively reduced chronic pain behaviors in this sample of older adults with dementia. The frequency of excess disabilities also showed a general decline throughout the study period. Finally, primary caregivers proved to be moderately reliable proxy informants of participants' pain. |
