Use of the assessment of discomfort in dementia protocol

The Assessment of Discomfort in Dementia (ADD) Protocol was developed to im prove recognition and treatment of physical pain and affective discomfort i n people with dementia who are no longer able to clearly or consistently re port on their internal states. The purpose of this study was to describe us e of each step of the ADD protocol with 143 residents of long-term care fac ilities. Of the subjects who received nonpharmacological comfort interventi ons, 37% showed improved symptoms. Of the 91 protocols in which an analgesi c was administered, 83.5% showed improved symptoms. People who complained v erbally received considerably more analgesics and other comfort interventio ns. Limitations inherent in this descriptive exploratory study do not permi t conclusions regarding the effectiveness of the ADD protocol. Research wit h a control group, random assignment, and objective measures of discomfort level is planned. Copyright (C) 2001 by W.B. Saunders Company.