Assessing and Managing Pain in Dementias: Insights From Interdisciplinary Text Message Communications.

The study counted mentions in text messages, not complete clinical records of pain assessment or treatment. Text message language was informal, so the extraction dictionary may have missed acronyms or slang for pain and may have counted unrelated phrases such as a painful decision. The pain word and medication dictionaries were created by the research team and were not exhaustive. The sample came from nursing homes in one Midwest state and was predominantly White, so it may not apply to more diverse settings. Facility staff training, pain assessment tools, and provider training for older adults with dementia were not measured and may have varied. The design was retrospective and observational, so it cannot show that lower pain mentions caused poor resident outcomes or that residents with ADRD actually received less pain treatment.

The article is marked as supported by NIH extramural research. The authors declared no known competing financial interests or personal relationships.

Do not conclude that residents with dementia received less pain treatment or had worse outcomes. This study counted mentions in transfer text messages, not actual pain assessments or treatments, and it did not test whether communication caused harm.