Australia’s population is ageing (Australian Bureau of Statistics, 2020) which has seen a corresponding rise in older adults admitted to acute care hospitals. As individuals age, pain-causing conditions become increasingly prominent reasons for seeking healthcare. Additionally, the prevalence of dementia is on the rise, with projections suggesting prevalence will more than double by 2058 (Australian Institute of Health and Welfare, 2023). Dementia is often associated with cognitive impairment (CI), which complicates pain assessment and management. Studies have shown that a significant proportion of people living with dementia regularly suffer from some degree of pain (Corbett et al., 2012; Sampson et al., 2015).
Pain in older people is often underestimated and undertreated, particularly patients with dementia in hospital settings, due to several factors including lack of guidelines and protocols; lack of initiation of pain assessment, and lack of use of appropriate pain assessment tools (Lichtner et al, 2016; Tsai et al 2018; Tsai et al, 2022). This is of serious concern as suboptimal pain assessment and management can lead to adverse physical and psychological patient outcomes (including reduced daily functioning and mobility, falls, depression and anxiety, sleep impairment, delirium, and behavioural symptoms) (Lichtner et al, 2016).
As evidence suggests existing guidelines are not informing clinical practice, a scoping review was undertaken to identify current pain assessment guidelines, policies and clinical protocols for patients with cognitive impairment in hospital. The Joanna Briggs Institute framework guided the review. Electronic databases, grey literature searches and documents made available by health care organisations were included.