Assessing advanced cancer pain in older adults with dementia at the end-of-life

Journal of Advanced Nursing

Volumn 68, Issue 9, 2012, Pages 2070-2078

  Monroe, Todd ^a   Carter, Michael ^b   Feldt, Karen ^c   Tolley, Betsey ^b   Cowan, Ronald L ^d  

^a University School of Nursing   (United States)

^b UNIVERSITY OF TENNESSEE HEALTH SCIENCE CENTER   (United States)

^c SEATTLE UNIVERSITY   (United States)

^d School of Medicine   (United States)

Author keywords

Alzheimer's disease; Cancer pain; Cognitive Performance Scale (CPS); Discomfort Behavioural Scale (DBS); Pain; Pain behaviours

Indexed keywords

ADULT; AGED; ALZHEIMER DISEASE; ARTICLE; BEHAVIOR; COGNITION; CROSS-SECTIONAL STUDY; FEMALE; HUMAN; MALE; METHODOLOGY; NEOPLASM; NURSING HOME; PAIN; PSYCHOLOGICAL ASPECT; RETROSPECTIVE STUDY; TERMINAL CARE; UNITED STATES; VERY ELDERLY;

ADULT; AGED; AGED, 80 AND OVER; ALZHEIMER DISEASE; BEHAVIOR; COGNITION; CROSS-SECTIONAL STUDIES; FEMALE; HUMANS; MALE; NEOPLASMS; NURSING HOMES; PAIN; RETROSPECTIVE STUDIES; TERMINAL CARE; UNITED STATES;

EID: 84864307818     PISSN: 03092402     EISSN: 13652648     Source Type: Journal    
DOI: 10.1111/j.1365-2648.2011.05929.x     Document Type: Article

References (37)

1. Alzheimer's Association (2011) Alzheimer's Disease Facts and Figures. Retrieved from on 17 October 2009.
2. Alzheimer's Disease International (2010) World Alzheimer's Report 2010. Retrieved from on 30 January 2011.
3. American Geriatrics Society Panel on Persistent Pain in Older Persons (2002) Clinical practice guidelines: the management of persistent pain in older persons. Journal of the American Geriatrics Society 50: S205-S224.
4. Arkansas Medicaid (2007) Opioid dosing conversion calculator.xls. retrieved from on 11 November 2007.
5. Bernabei R., Gambassi G., Lapane K., Landi F., Gatsonis C., Dunlop R., Lipsitz L., Steel K. & Mor V. (1998) Management of pain in elderly patients with cancer. SAGE Study Group. Systematic assessment of geriatric drug use via epidemiology.[Erratum appears in JAMA 1999 Jan 13;281(2):136]. JAMA 279(23): 1877-1882.
6. Blixen C. & Kippes C (2007) Depression, social support, and quality of life in older adults with osteoarthritis. Journal of Nursing Scholarship 31(3), 221-226.
7. Chibnall J.T. & Tait R.C. (2001) Pain assessment in cognitively impaired and unimpaired older adults: a comparison of four scales. Pain 92(1), 173-186.
8. Cole L.J., Farrell M.J., Duff E.P., Barber J.B., Egan G.F. & Gibson S.J. (2006) Pain sensitivity and fMRI pain-related brain activity in Alzheimer's disease. Brain: A Journal of Neurology 129(Part 11), 2957-2965.
9. Delacourte A., David J., Seargeant N., Buee L., Wattez A., Vermersch P., Ghozali F., Fallet-Bianco C., Pasquier F., Lebert F., Petit H. & Di Menza C. (1999) The biochemical pathway of neurofibillary degeneration in aging and Alzheimer's disease. Neurology 52, 1158-1165.
10. Elliott A.F. & Horgas A.L. (2009) Effects of an analgesic trial in reducing pain behaviors in community-dwelling older adults with dementia. Nursing Research 58(2), 140-145.
11. Ferrell B.A., Ferrell B.R. & Rivera L. (1995) Pain in cognitively impaired nursing home patients. Journal of Pain & Symptom Management 10(8), 591-598.
12. Gruber-Baldini A.L., Zimmerman S.I., Mortimore E. & Magaziner J. (2000) The validity of the minimum data set in measuring the cognitive impairment of persons admitted to nursing homes. [Comparative Study Research Support, U.S. Gov't, P.H.S. Validation Studies]. Journal of the American Geriatrics Society 48(12), 1601-1606.
13. Hawes C., Morris J., Phillips C. & Mor V. (1995) Reliability estimates for the minimum data set for nursing home resident assessment and care screening (MDS). The Gerontologist 35(2), 172-179.
14. Herr K.A. & Garand L. (2001) Assessment and measurement of pain in older adults. Clinics in Geriatric Medicine 17(3), 457-478.
15. Herr K., Coyne P., Key T., Manworren R., McCaffery M., Merkel S., Pelosi-Kelley J. & Wild J. (2006) Pain assessment in the nonverbal patient: position statement with clinical practice recommendations. Pain Management Nursing 7, 44-52.
16. Herr K., Bursch H., Miller L. & Swafford K. (2010) Use of pain-behavioral assessment tools in the nursing home, expert consensus recommendations for practice. Journal of Gerontological Nursing 36(3), 19-29.
17. Horgas A. & Miller L. (2008) Pain assessment in people with dementia. American Journal of Nursing 108(7), 62-71.
18. Lynn J., Teno J.M., Phillips R.S., Wu A.W., Desbiens N., Harrold J., Claessens M.T., Wenger N., Kreling B. & Connors A.F. Jr (1997) Perceptions by family members of the dying experience of older and seriously ill patients. Annals of Internal Medicine 126(2), 97-106. doi:.
19. Magaziner J., German P, Zimmerman S.I., Hebel J.R., Burton L., Gruber-Baldini A.L., May C. & Kittner S. (2000) The prevalence of dementia in a statewide sample of new nursing home admissions aged 65 and older: diagnosis by expert panel. Gerontologist 40, 663-672.
20. McCaffery M. (1968) Nursing Practice Theories Related to Cognition, Bodily Pain, and Man-Enviornment Interactions. University of California Los Angeles Students' Store, Los Angeles.
21. Mentes J., Culp K., Maas M. & Rantz M. (1999) Acute confusion indicators: risk factors and prevalence using MDS data. Research in Nursing & Health 22(2), 95-105.
22. Mitchell S., Kiely D. & Hamel M. (2004) Dying with advanced dementia in the nursing home. Archives of Internal Medicine 164(3), 321-326.
23. Monroe T. & Carter M. (2010) A retrospective pilot study of African American and Caucasian nursing home residents with cancer and dementia. Journal of Pain and Symptom Management 40(4), e1-e3.
24. Mor V., Angelelli J., Jones R., Roy J., Moore T. & Morris J. (2003) Inter-rater reliability of nursing home quality indicators in the U.S. BMC Health Services Research 3, 1-13.
25. Morris J., Brant E., Fries D., Mehr C., Phillips C., Mor V. & Lipsitz L. (1994) MDS cognitive performance scale. Journal of Gerontology 49(4), m174-m182.
26. Paquay L., De Lepeleire J., Schoenmakers B., Ylieff M., Fontaine O. & Buntinx F. (2007) Comparison of the diagnostic accuracy of the cognitive performance scale (minimum data set) and the mini-mental state exam for the detection of cognitive impairment in nursing home residents. International Journal of Geriatric Psychiatry 22(4), 286-293.
27. Pautex S., Michon A., Guedira M., Emond H., Lous P.L., Samaras D., Michel J.-P., Herrmann F., Giannakopoulos P. & Gold G. (2006) Pain in severe dementia: self-assessment or observational scales? Journal of the American Geriatrics Society 54(7), 1040-1045. doi:.
28. Roy R. & Thomas M. (1986) A survey of chronic pain in an elderly population. Canadian Family Physician 32, 513-516.
29. Rub U., Del Tredici K., Del Turco D. & Braak H. (2002) The intralaminar nuclei assigned to the medial pain system and other components of this system are early and progressively affected by the Alzheimer's disease-related cytoskeletal pathology. Journal of Chemical Neuroanatomy 23, 279-290.
30. Scherder E., Bouma A., Borkent M. & Rahman O. (1999) Alzheimer patients report less pain intensity and pain affect than non-demented elderly. Psychiatry 62(3), 265-272.
31. Stevenson K.M., Brown R.L., Dahl J.L., Ward S.E. & Brown M.S. (2006) The discomfort behavior scale: a measure of discomfort in the cognitively impaired based on the minimum data set 2.0. Research in Nursing & Health 29(6), 576-587.
32. Thome B. & Hallberg I. (2004) Quality of life in older people with cancer - a gender perspective. European Journal of Cancer Care 13, 454-463.
33. Tsai P.F., Beck C., Richards K.C., Phillips L., Roberson P.K. & Evans J. (2008) The pain behaviors for osteoarthritis instrument for cognitively impaired elders (PBOICIE). Research in Gerontological Nursing 1(2), 116-122.
34. US Cancer Statistics Working Group (2008) United States Cancer Statistics: 1999-2004 Incidence and Mortality Web-based Report. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute. Retrieved from All on accessed 5 January 2012.
35. US Department of Health Human Services (2000) Minimum Data Set (MDS) Version 2.0. 2008 (July 12).
36. US Department of Health Human Services (2004) Fact Sheet: metastic cancer questions and answers. 2010 (June 15).
37. Yates P., Fentunan B. & Dewar A. (1995) Pain: the views of elderly people living in long-term residential care settings. Journal of Advanced Nursing 21(4), 667-674. doi: 10.1046/j.1365-2648.1995.21040667.x.