On subsequent nursing visits, Mr. A. grew increasingly agitated and disorientated.
He was referred for an emergency appointment with his dementia nurse who diagnosed late-stage dementia. He died a few months following the nursing appointment presented. ConclusionIn conclusion, effective pain management is essential for patients suffering from cancer and dementia, effecting a wide-range of health outcomes.
In this case, pain may have significantly contributed to Mr. A’s anxiety and distress and was therefore potentially preventable and could have given him better quality of life in his last year. An effective nursing assessment is crucial in identifying care needs such as escalated pain management; however, it can be problematic with patients suffering from impaired communication. Consequently, in the dementia population pain is often undetected and poorly managed according to the literature. Mr. A.’s case exemplifies how a lack of regular and comprehensive assessments can lead to patients suffering serious outcomes.
Non-observational tools are invaluable and recommended when assessing patients with dementia, are easy to use and can be carried out by carers who have the most contact with the patient. Interestingly, art therapy may be a useful addition to nursing practice, improving overall well-being. In future practice, such tools should always be used as part of a holistic assessment for patients with dementia, ensuring that an accurate nursing assessment informs a subsequent care plan that is tailored to the patient’s needs. Appendix A – PACSLAC-II assessment tool. org/sites/geriatricpain.org/files/wysiwyg_uploads/pacslac-ii_tool_with_logo.pdf>Appendix B – Care plan Nursing Intervention Rationale Increased frequency of swallowing assessments and informing carers to be aware and refer to nurse if Mr A. has any choking episodes or seems more bothered by his throat. Mr A. has a risk of choking due to his dementia and with the increasing mass of his tumour so more assessments can help manage this risk by identifying changes quickly. Carers are with him the most so will be best placed to notice any sudden changes. Continued pain management and monitoring Increasing pain is likely as his cancer progresses and a step-wise approach can be used to address any additional pain. Giving warm/cold drinks May provide some relief to any throat discomfort Mr A. is experiencing to help in pain management. Mr A. appeared to get some relief from a cold drink. Encourage to participate in group activities and sit in day room To increase Mr A.’s social interaction and well-bring, which may reduce his anxiety and distress. Encourage to sit in chair next to window every day Mr A. seemed calm by looking at the garden. It is also a form of art therapy that reduces anxiety and distress.
