A 93-year-old man in a care home has advanced dementia, is bedbound, and has a Barthel Index of 0/20. He has been intermittently groaning and grimacin...

Question

A 93-year-old man in a care home has advanced dementia, is bedbound, and has a Barthel Index of 0/20. He has been intermittently groaning and grimacing during care activities for the past 2 weeks. He has a known chronic sacral pressure ulcer. His Abbey Pain Scale score is 10 (moderate pain). He cannot swallow tablets. What is the MOST appropriate analgesic approach?

Accepted Answer

Start Paracetamol suppositories 1 g QDS and reassess

Answer

Start Morphine Sulphate oral solution 2.5 mg PRN

Answer

Apply a Buprenorphine 5 microgram/hour transdermal patch

Answer

Administer Diclofenac 75 mg intramuscularly daily

Answer

No analgesia as pain cannot be confirmed in advanced dementia

uk-dgm MCQ (SBA): Analgesic Prescribing in Non-Verbal Dementia Patient