People with dementia become more sensitive to pain as the damage to the brain becomes more severe. This is evident from research by PhD student Steffie Bunk of the UMCG. The research emphasizes the importance of timely pain detection. The pain observation instrument PAIC15, developed by the University Network for Elderly Care UMCG (UNO-UMCG), can help with this.
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Half to three quarters of people with dementia experience pain. Researcher Steffie Bunk: “In dementia, the nerve cells and the connections between those nerve cells break down, causing the brain to work less well and pain being processed differently.” People with advanced dementia in a nursing home are often no longer able to indicate that they are in pain. They depend on the observations of carers and nurses. The PAIC15 ensures that healthcare professionals pay attention to 15 signals of pain, including facial expressions and body movements.
Processing pain in the brain
Bunk wanted to know whether people with advanced dementia are not only less able to indicate that they are in pain, but also whether they are more sensitive to pain. She used mild pain stimuli to investigate whether the processing of pain changes due to dementia. She also examined with an MRI scan which changes in the brain play a role in this. Twenty-three elderly people with mild dementia took part in the study. Bunk compared the results with those of a healthy group of elderly people.
Facial expression betrays pain
“When you ask ‘does this hurt?’ you see no difference in response between healthy elderly and elderly with mild dementia. If you look at the facial expression, you can see a difference: elderly people with dementia do show more signs of pain. You can therefore already see this higher sensitivity to pain in mild dementia. The results of my research make the signaling of pain by healthcare professionals extra important ”, Bunk emphasizes.
Practical research
The pain observation instrument PAIC15 has been developed within the UNO-UMCG, a network of twenty elderly care organizations and the UMCG in the north and east of the Netherlands. This network focuses on improving care for the elderly through practice-oriented scientific research and knowledge sharing. More and more nursing homes are using the PAIC15 to timely recognize and treat pain in people with dementia.
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