Les défis de l'évaluation de la douleur chez la personne âgée avec des capacités réduites à communiquer en raison d'une démence avancée

An increasing number of us now reach old age because of the constant and predictable rise in life expectancy. This is inevitably associated with a higher risk of developing and cumulating health problems of varying severity, giving rise to acute or chronic pain. In these cases, seniors capable of expressing themselves can obtain appropriate pain relief from competent health professionals. Apart from physical health problems, old age is also invariably accompanied by an increased risk of suffering from the cognitive deficits linked with Alzheimer's disease and other related conditions. When the moderate or severe stages of those diseases are reached, seniors who are already physically in pain also become progressively incapable of expressing themselves and obtaining the relief that is still needed. Those vulnerable and frail seniors should then be able to count on motivated and competent health professionals who are supported and trained by organizations ready to detect pain in patients who cannot communicate, but still suffer. High quality tools for identifying and assessing pain have been validated and are available to health care teams. They now need to be implemented as part of comprehensive management programs focusing on awareness building, knowledge and skill development, as well as systematic monitoring by multidisciplinary teams, in order to improve our collective efficiency in terms of pain relief.