The recently published systematic review conducted by the research team around Lihui Pu Madushika highlights the decision-making process involved in pain assessment and management for people living with dementia. The team focused on the different steps to decision-making and the key decisions by people with dementia, and their informal and formal carers, to create a model based on these results. Within the publication, the various steps of decision-making and the key choices made by both individuals with dementia and their formal and informal caregivers to develop a model based on their findings were examined. The research team’s main take-home message was the difference between pain assessment and pain management.
While both represent complex, collaborative and dynamic decision-making processes between the person with dementia and their formal/informal carers, pain assessment seems to involve a certain degree of guesswork, while pain management is more a trial-and-error procedure of pain-relieving interventions. In both cases, decisions are based on the understanding of the person with dementia and go along with high uncertainty. According to the authors, their findings emphasise the need for a pragmatic approach to overcome the challenges of effective pain management in people with dementia. Based on their findings, a model was developed to help guide future implementations of decision-making in pain assessment and management. Lihui Pu Madushika and colleagues concluded that more pragmatic approaches are required to overcome challenges, especially uncertainty and decisional conflicts. Please follow the link to read the full paper: