Joint Statement on Opioid Prescribing for Palliative Care
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 some tragic stories affecting some of the most vulnerable people in our communities.
Behind all the public outcry and examination of policy failure are over a million older Australians who live with chronic pain, with rates of pain almost twice as high as the working age population. It is estimated up to 80% of aged care residents have chronic pain.
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 these past weeks.
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 related to recent regulatory responses to opioid prescribing and restrictions and unintended consequences suffered by people who arguably most rely on pain relief, people receiving palliative care.