An older adult receiving hospice care has dementia as a result of metastasis to the brain.His bone cancer has progressed to an advanced stage.Why might the client fail to request pain medication as needed? The client:

A) Experiences less pain than in earlier stages of cancer
B) Cannot communicate the character of his pain effectively
C) Knowledges pain at a later time than when it occurs
D) Relies on caregiver to provide pain relief without asking

There is no evidence to suggest that patients with dementia and other forms of cognitive impairment do not experience pain.It is most likely that they cannot effectively communicate the intensity or quality of pain and are therefore at risk for underassessment of pain and inadequate pain relief.Be aware of behavioral cues indicating pain rather than relying on verbal report.Failure to request pain medication is not likely a result of hesitation to habitually ask for it or reliance on others; rather,it is likely owing to inability to effectively express to the caregiver that analgesia is needed.