Use of the Assessment of Discomfort in Dementia Protocol

• Published in: Applied nursing research Vol. 14; no. 4; pp. 193 - 200
• Main Authors: Kovach, Christine R., Noonan, Patricia E., Griffie, Julie, Muchka, Sandy, Weissman, David E.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-11-2001
• Subjects: Aged; Aged, 80 and over; Alzheimer Disease - complications; Alzheimer Disease - nursing; Clinical Protocols; Dementia - complications; Dementia - nursing; Female; Humans; Male; Middle Aged; Midwestern United States; Nursing; Pain - complications; Pain - diagnosis; Pain - nursing; Pain Measurement - methods; Stress, Psychological - complications; Stress, Psychological - diagnosis; Stress, Psychological - nursing; Midwestern United States
• ISSN: 0897-1897; 1532-8201
• DOI: 10.1053/apnr.2001.26784

The Assessment of Discomfort in Dementia (ADD) Protocol was developed to improve recognition and treatment of physical pain and affective discomfort in people with dementia who are no longer able to clearly or consistently report on their internal states. The purpose of this study was to describe use of each step of the ADD protocol with 143 residents of long-term care facilities. Of the subjects who received nonpharmacological comfort interventions, 37% showed improved symptoms. Of the 91 protocols in which an analgesic was administered, 83.5% showed improved symptoms. People who complained verbally received considerably more analgesics and other comfort interventions. Limitations inherent in this descriptive exploratory study do not permit conclusions regarding the effectiveness of the ADD protocol. Research with a control group, random assignment, and objective measures of discomfort level is planned.