A 85-year-old woman with severe Alzheimer's disease (MMSE 6/30) is in a care home. She has become increasingly withdrawn, refusing food and spending m...

Question

A 85-year-old woman with severe Alzheimer's disease (MMSE 6/30) is in a care home. She has become increasingly withdrawn, refusing food and spending most of the day in bed. She appears to be in pain during care activities (grimacing, guarding). Her Abbey Pain Scale score is 12. She is currently on no analgesia. What is the MOST appropriate first step?

Accepted Answer

Start regular Paracetamol 500 mg-1 g QDS and reassess

Answer

Prescribe Morphine Sulphate oral solution 5 mg QDS

Answer

Refer for a CT scan to identify the source of pain

Answer

Assume the behaviours are due to dementia progression and observe

Answer

Prescribe Pregabalin 75 mg BD

uk-dgm MCQ (SBA): Pain Assessment and Management in Dementia