A new scoping review looked at pain assessment guidelines for hospitalized older adults with cognitive impairment, including dementia. The researchers searched databases and the internet for guidelines that could help hospital staff assess pain in patients who may have trouble communicating.
They found no Australian guidelines in the database search. Through an internet search, they identified 56 potential guidelines, but only 9 met their criteria. Of those 9, 2 provided no practical guidance at all, and 7 only offered brief narrative descriptions without step-by-step instructions.
The most frequently recommended pain assessment tools were the Pain Assessment in Advanced Dementia (PAINAD) scale and the Abbey Pain Scale. However, the review did not test these tools or compare them to other methods.
This was a scoping review, not a clinical trial, so it maps existing guidelines rather than testing a treatment. The main takeaway is that there is a lack of practical, easy-to-use pain assessment guidelines for this vulnerable group, especially in Australia. More work is needed to develop clear guidance for hospital staff.
