Dementia patients often have diminished sensory perception at the advanced stages and may not detect discomfort or pain, even if they do in fact have pressure ulcers (or are at high risk), according to the Annals of Long-Term Care article cited earlier. Also, the Braden Scale doesn’t account for the presence of pressure ulcers or a patient’s history of having them. This means the Braden score may not accurately reflect a resident’s risk, or even whether they currently have pressure ulcers. Therefore, the nurse must use their best judgment with dementia patients, also considering their history of wounds, use of steroids or chemotherapy, time on an operating room table, actual skin issues, and other factors.