Behavioral pain assessment tools are able to detect pain, but they have little evidence in identifying the intensity or location of pain (Lukas et al., 2012). The pain scales can also inaccurately detect pain if behaviors are present for other reasons of distress such as anxiety or hunger (Lukas et al., 2012). The current clinical guidelines for pain assessment in older adults recommends that nurses use an individualized and comprehensive approach, which includes the use a hierarchy of assessment methods (Hartford Institute for Geriatric Nursing, 2012). Regardless of the patient’s cognitive abilities, nurses should attempt a self-report initially because it is the most accurate (Herr, Coyne, McCaffery, Manworren, & Merkel, 2011). After attempting a self-report, nurses should assess for a source of pain, observe for behavior changes through the use of a behavioral pain assessment tool, and obtain a proxy rating if a caregiver or family member is present (Herr et al., …show more content…
Park (2010) determined that patients with moderate to severe dementia had considerable lower pain levels after listening to music for 30 minutes. Touch is another type of non-pharmacological intervention that can reduce pain and promote relaxation. Meland (2009) followed six case studies of patients with dementia (three were classified with severe dementia) who participated in Reiki therapy for four weeks and determined that the patients had decreased pain and increased socialization after therapy. The results of Hodgson and Andersen’s study (2008) indicated that patients with dementia had decreased pain levels after participating in four weeks of reflexology treatment. The participants in the study were classified as having mild-to-moderate dementia, so additional testing on severe dementia may be