Figure 2.

Total pain of dementia patients receiving palliative care.

Pain in advanced dementia can be understood as having physical, psychological, social, and spiritual components. Pain was not just a physical sensation: it might be a consequence of psychological and psychiatric symptoms, loneliness, spiritual distress, or daily life environment. The combination of these elements results in a “total pain” experience that is individualized and specific to each patient’s particular situation. Whether or not patients with advanced dementia report pain, hurting, or suffering, it is important to assess these experiences through a multidimensional lens that allows for the appreciation of all possible causes and influences.