Journal of the American Medical Directors Association
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To evaluate the interrater reliability of a structured delirium assessment method for nonclinician interviewers in elderly patients newly admitted for postacute care. ⋯ Nonclinician interviewers using a structured delirium assessment achieved reliability that rivaled or exceeded that of trained clinical assessors in other studies. Nonclinicians may offer an effective alternative for the assessment of delirium among postacute patients in skilled nursing facilities.
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Case Reports
Finding the person behind the pain: chronic pain management in a patient with traumatic brain injury.
Chronic pain is common after a traumatic brain injury. Cognitive impairment post injury may be a consequence of the brain injury alone, or in combination with pain, clinical depression, and psychological and emotional factors. ⋯ The introduction of an opioid made a significant improvement in the cognition and quality of life of the individual. This case suggests that clinicians should consider a trial of opioid analgesics in individuals with brain injury who have significant cognitive impairment in association with other behaviors suggestive of depression and pain.