Some dementia patients in hospital ‘suffering in silence’, study warns

Older hospital patients with dementia may be “suffering in silence” because they are unable to communicate the pain they are in, a new study suggests.

Experts from the Marie Curie Palliative Care Research Department at University College London set out to investigate the link between pain and delirium among people with dementia admitted to hospital.

They said that both pain and delirium are common among dementia patients on hospital wards but these conditions are “often under-diagnosed and under-treated”.

Delirium is a state of acute confusion which can particularly affect older people.

The team set out to examine the dementia severity, delirium and pain levels among 230 dementia patients aged 70 and over admitted to two British hospitals.

They found that almost half (49%) of the patients studied were suffering pain while resting, and delirium developed in 15%.

Of the 35% of participants who were delirious and unable to self-report pain, 33% of these participants experienced pain at rest, according to the study, published in the journal Age And Ageing.

The odds of being delirious were 3.26 times higher in participants experiencing pain at rest, according to the study, jointly funded by Alzheimer’s Society and Bupa Foundation, and supported by the terminal illness charity Marie Curie.

The authors concluded that pain may be a cause of delirium.

The team urged hospital staff to carry out regular assessments so that pain and delirium are managed effectively.

“In the UK, almost half of people admitted to hospital over the age of 70 will have dementia,” said Dr Liz Sampson, of the Marie Curie Palliative Care Research Department at University College London.

“We know that they are a high-risk group for delirium and yet delirium is often under-treated.

“Our latest work suggests that pain could be a cause of delirium.

“It’s deeply troubling to think that this vulnerable group of patients are suffering in silence, unable to tell healthcare professionals that they are in pain.

“Studies like this may help hospital staff provide better care now and in the future as dementia diagnosis rates continue to rise.”

Dr Doug Brown, chief policy and research officer at Alzheimer’s Society, added: “We know that people living with dementia can find it difficult to communicate, and when this concerns inability to communicate pain to hospital staff, it’s clearly extremely concerning, as it’s not only upsetting and frustrating but can have serious consequences on a person’s health.

“The link this research shows between delirium and pain shows that the problem may be worse than previously realised.

“We now need to take steps to ensure that all healthcare professionals have the right training to identify such distress in order to properly care for people with dementia.”