Factors Associated With Pain Among Hospitalized Older Adults Living With Dementia.

Abstract

Purpose: The purpose of this study was to consider the factors associated with change in function, physical activity, behavioral symptoms and participation in function focused care among hospitalized older adults living with dementia.

Design: This was a secondary data analysis using data from the Function Focused Care for Acute Care Using the Evidence Integration Theory (FFC-AC-EIT) study to increase physical activity among hospitalized older adults living with dementia.

Methods: A total of 455 patients were recruited from 12 hospitals across two states. Hospitals were randomized to receive the FFC-AC-EIT intervention versus Education Only (EO). Structural Equation Modeling using the Amos statistical program was used to test the hypothesized model.

Results: The mean age of the participants was 83.9 (SD = 8.3), the majority was female (63%) and White (65%). Tethering, exposure to FFC-AC-EIT, cognition, and nonpharmacologic interventions were associated with pain and pain mediated the relationship between these variables and change in function, behavioral symptoms and physical activity.

Conclusions: There are many factors associated with changes in function and behavioral symptoms among hospitalized patients with dementia. The findings from this study provide an important reminder about the critical importance of pain and support the use of nonpharmacologic interventions (e.g., physical activity, position changes and removing tethers) to optimize pain management and improve clinical outcomes among older hospitalized patients living with dementia.

Clinical implications: The findings support use of nonpharmacologic interventions including physical activity, position changes and removing tethers as soon as it is clinically reasonable to do so to optimize pain management among older hospitalized patients living with dementia.