According to the Australian Pain Society, pain is experienced by as many as 93 per cent of residents in aged care homes. Too often pain is not recognised as a factor affecting an older person's quality of life, or dismissed lightly if it is. The situation is even more concerning for people with dementia – especially those who can no longer clearly articulate their pain needs.
Unidentified and undertreated pain can significantly reduce the quality of life for the individual and increase the risk of falls, depression and anxiety. Adequately responding to pain experienced by people living with dementia is a care imperative in residential aged care homes, where over 50 per cent of residents are identified as having dementia.
Despite the development of a range of best practice pain management guidelines and resources, current research suggests that the translation of this evidence into practice has had mixed outcomes. Studies have shown that key challenges to best practice management of pain in older people living with dementia include limited use of pain assessment tools, and lack of capability and confidence among aged care staff to interpret pain cues and then initiate treatment.
Intervene Phase 2, an implementation project by HammondCare's Dementia Centre was set up to address this evidence-practice gap. The project draws on the findings of a pilot study, Intervene Phase 1, which revealed persistent challenges in managing pain effectively, including identification and assessment of pain.
The project, currently running in four residential aged care services in NSW and Victoria, aims to improve pain management for people living with dementia by empowering personal care staff to be more actively engaged in the process. Researchers are working with teams at each service to identify barriers to the implementation of best practice pain management, and to develop strategies and training tools to improve how pain is identified, assessed, treated and managed for people living with dementia.
Dementia Support Australia (DSA) is an Australian government-funded national partnership led by HammondCare that incorporates the Dementia Behaviour Management Advisory Service (DBMAS) and the Severe Behaviour Response Teams (SBRT). The service brings a diverse range of dementia expertise from across the aged care industry of Australia through a network of offices across the country.
DSA consultants including specialists in geriatrics, psychogeriatrics, pain medicine, rheumatology and palliative care provide timely, on-the-ground support, maintaining local knowledge and relationships. Individual consultation with the interdisciplinary team is provided through the Greenwich Pain Clinic and via telehealth from residential aged care facilities.
DSA recently partnered with PainChek to use its iPhone app to assist its consultants to identify pain in people living with dementia particularly those who have challenges with verbal communication.
HammondCare’s Staff Specialist - Pain Medicine and Rheumatology, Dementia Care and Pain Clinic, Dr Raj Anand (pictured), says effective pain management is an essential part of aged care.
“Pain is a contributing factor to changed behaviours in people living with dementia in up to 80 per cent of the cases,” he said.
“Pain is therefore everyone’s business and it is essential to manage pain effectively to improve a person’s quality of life, improve the experience of caring and reduce the need for psychotropic medications.
“Optimal pain management involves understanding the person and a coordinated approach amongst all the healthcare providers including carers.”
Painaustralia congratulates HammondCare on its forward-thinking approach and its pro-active iniitatives that are helping to optimise pain care for our vulnerable older Australians.