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Assessment and treatment of persistent pain in persons with cognitive and communicative impairment
Author(s) -
Snow A. Lynn,
Jr. John L. Shuster
Publication year - 2006
Publication title -
journal of clinical psychology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.124
H-Index - 119
eISSN - 1097-4679
pISSN - 0021-9762
DOI - 10.1002/jclp.20317
Subject(s) - psychology , dementia , population , pain assessment , cognition , clinical psychology , psychiatry , cognitive impairment , psychotherapist , pain management , physical therapy , medicine , disease , environmental health , pathology
Pain management is a challenge when working with persons who have cognitive impairment that affects their ability to understand and communicate. This article focuses on pain assessment and treatment in persons who have dementia, but the challenges and principles are relevant to the spectrum of cognitive impairment. Fundamental principles guiding pain assessment and treatment in this population are (1) that behavioral disturbance is the result of an unmet need that causes discomfort, (2) that the behavioral disturbances that result from the unmet need of uncontrolled pain may be identical to those caused by other unmet needs (e.g., thirst, needing to toilet, understimulation, overstimulation, depression, psychosis, uncomfortable clothing), and therefore (3) that any pain treatment protocol for this population must target discomfort behaviors in general and then attempt to determine their causes. Pain assessment and treatment approaches based on these principles are outlined, and then two cases are presented to illustrate the application of these approaches. © 2006 Wiley Periodicals, Inc. J Clin Psychol: In Session 62: 1379–1387, 2006.