The month of May has brought with it the second round of public evidence hearings for the Royal Commission into Aged Care Safety and Quality. Shocking and heartbreaking testimonials from families and aged care workers have revealed the utter neglect, cruelty and abuse that some of the most vulnerable people in our communities have endured.
Behind all the public outcry and examination of policy failure are the stark faces of over a million older Australians who live with chronic pain, with rates almost twice as high as the working age population. It is estimated up to 80% of aged care residents have chronic pain.[i],[ii]
Pain is now being recognised as a significant factor in behavioural and psychological symptoms of dementia (BPSD). When you consider that people living with dementia account for nearly 50% of those living in residential aged care facilities, it is easy to see how untreated chronic pain can result in BPSD, which can further lead to some of the horrific incidents of the inappropriate use of chemical and physical restraints and elder abuse that we have heard this week.
So how are we managing pain in aged care? Clearly what we are doing is not enough, and most distressing is the way we manage pain at end of life. Stories shared by consumers in our networks paint a story of older people left suffering through their final days, waiting in angst for pain relief that often arrives too late.
While inadequate staff training, and insufficient funding to support best practice pain management do contribute to many of the pain management issues we see in aged care, some of the barriers are of our own making. Recent regulatory responses to opioid prescribing have seen restrictions and unintended consequences suffered by people who arguably most rely on pain relief, people receiving palliative care.
This is why Painaustralia has joined Palliative Care Australia and other peak health organisations today in calling for an approach that ensures sustainable access to opioids for Australians receiving palliative care. It is time we look beyond the blinkered approach of fixing just aged care or particular health issues and recognise that we need to work together to deliver the one thing that is crucial across our all our individual mandates: better care for all Australians.
Carol Bennett, CEO.
[i] Gibson SJ, Improvement of Pain Management in Residential Aged Care, Issues Paper
[ii] Zwakhalen S, Pain in elderly people with severe dementia: A systematic review of behavioural pain assessment tools, BMC Geriatrics 2006;6:3