Where the client's doctor has stipulated a clear and specific course of treatment and medication, caregivers, family members and the client have an easier time with managing that pain. All too often, however, the doctor has prescribed pain medication to be taken PRN (pro re nata), meaning as needed by the client.
As long as the client does not suffer from dementia, that is still manageable for caregivers, family and the client her- or himself. But what happens if the client does have dementia. The doctor often recommends that the pain medication be given when the pain level is above X (provided the maximum dosage has not been reached).
The other day, however, our Director of Client Services was meeting with a client and asked her what pain level she was at, on a scale of 1-10. The client, however, was unable to grasp that scale. She could not really manage to put a number on her pain.
Knowing where the client is, in terms of pain level, is critical to complying with doctor's orders. In these situations, a tool our Director of Client Services often uses is the Wong-Baker Pain Rating Scale(c). That scale goes from a big smile on the left to tears on the right, in a total of six faces. This tool was developed for use in pediatrics, but works well with some seniors with dementia.
Best wishes, Bert
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