Pain management: a fundamental component of dementia care.

Pain is a multifaceted experience with physical, psychological, social and spiritual components. Dementia, which is often accompanied by impaired communication, complicates the assessment and treatment of pain. Although older people with dementia share the same age-related pathology as other older people, they do not experience the same access to pain relief as their cognitively-unimpaired counterparts. Tools have been developed to enhance self-reporting of pain by people with dementia and the objective observation of non-verbal signs of pain. The first step, however, is awareness that pain might be present and can be responsible for otherwise unexplained distress and behaviour change. Recognition of pain should trigger the appropriate and timely use of pain assessment tools. Pharmaceutical and non-pharmaceutical measures to relieve pain should be used as appropriate. Evaluation of the efficacy of these methods is needed on an ongoing basis. People living with dementia deserve to be listened to, no matter how they choose to express pain, and to have their pain minimised effectively and efficiently.