Case report: A patient with dementia presenting with hip fracture in the emergency department – Challenges of acute pain assessment

The purpose of this case report is to stimulate debate on the practicalities of detecting pain in patients with dementia in the emergency department (ED) – in this case, a patient who sustained a hip fracture subsequent to a fall in a nursing home. Although case reports are low in the hierarchy of evidence, they serve as useful glimpses into future possible detection and management of the pain status of the person with dementia in the ED who present with injuries such as hip fractures. Older patients with dementia, who are unable to provide a self-report of pain post hip fracture in the ED are at risk for under-detection and under-treatment of acute pain. The utilisation of a specific pain assessment framework, based on best available evidence, will enable nurses to detect and manage acute pain for this vulnerable group in the emergency department.