Análise de instrumentos para avaliação e mensuração da dor e sofrimento em idosos portadores de demência

Abstract

Population aging is a worldwide phenomenon, and in Brazil predictions by the World Health Organization (WHO) foresee 30 million seniors by the year 2025. This age group corresponds to 10% of the population, bringing the country to occupy the sixth position among the countries with the highest number of elderly people in the world. In order to ensure better quality of life for the elderly population, it is essential to assess the morbidity factors to which this population is exposed. Many health conditions that present with advancing age are accompanied by pain and suffering, and in a large part of them, chronic pain is the main complaint and the most frequent symptom in the case histories, occurring in 25% -50% of patients. The presence of pain may be denied for various reasons, such as: fear of medical procedures and the costs incurred, loss of autonomy and possible institutionalization. Moreover, the presence of conditions such as depression, sequel of stroke and dementia can complicate expression, or even, depending on the case, makes communication of pain by the patient impossible. The aim of this review paper is to analyze the scales of assessment and measurement of pain and suffering in elderly patients with dementia. Articles used are from 1988 to 2009, surveyed in the electronic databases Medline, PubMed, Lilacs and Cochrane. We found nine instruments to measure pain in the elderly and after reading the summary and the criteria for inclusion and exclusion, five were selected for this study. The reading of these studies leads to the perceived need for additional research to make the most accurate measurement of pain. Also stressed in the studies is the reduced sampling as well as difficulties related to the education of professionals dealing with patients who are unable to communicate their pain. Despite these limitations, the tools reviewed are reliable and valid for treatment of patients with chronic pain and to improve their quality of life.