Question

Your patient is an 82-year-old woman with mild vascular dementia who has fallen and broken her pelvis. It is a stable fracture and will not be surgically fixed. The physician has ordered physical and occupational therapy and pain management. One family member tells you that because she has dementia she will not need pain medication. Another family member tells you that they do not want her to have pain medication because they are Christian Scientists.

1. What challenges might you face in assessing her pain and how might you handle those challenges?

2. How should the care team respond to the family’s concerns about treating her pain?

Answer 1

1. As she is suffering from dementia i have to face challenges like identifying , localise and access pain dementia patients have same amount of pain like the normal people ,but they cannot communicate and express with others due to decreased cognitive functioning - so i have to handle the situation with non -verbal signs which can be seen in any stage of dementia

Non verbal signs are -

gestures that indicate pain , crying or distress, moaning with movement, restlessness

2. Care team should educate the family member that a dementia patient also suffer from pain but they cannot express or communicate with others

Care team should shift them to Christian science nursing as they wish treatment through prayer