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Better equipping healthcare professionals in pain management of people with dementia

Journal Article


Abstract


  • Pain management for individuals living with a dementia is one area of nursing care which

    needs improved. As a dementia progresses, verbal language skills can deteriorate and

    individuals rely more on non-verbal ways of communicating. It can become difficult, if not

    impossible, for individuals living with dementia to use words to explain their pain to

    someone else. Individuals living with a dementia then become at high risk of living with

    chronic pain. And, not unsurprisingly, this has a negative effect on their quality of life which

    in turn causes further deterioration of an individual’s dementia and high levels of stress for

    family and healthcare professionals providing care.

    It is estimated up to 80% of older people living in nursing homes experience chronic pain and

    in Australia more than half of these older people (52%) have a diagnosis of dementia while

    two in three (67%) require high-level care to manage distress situation (Gibson, 2007;

    Zwakhalen, 2006). We can therefore assume that a high proportion of people with chronic

    pain also have cognitive impairment and will have difficulties in verbally expressing their

    pain. The Australian Pain Society (2005) reported that individuals living with a dementia

    who experience pain have their pain left untreated at higher rates that those without dementia.

    In one study, pain was detected in just 31.5% of cognitively-impaired residents compared to

    61% of cognitively-intact residents, despite both groups being equally afflicted with

    potentially painful disease (Proctor & Hirdes, 2001).

    This situation can be avoided using close observation of non-verbal expressions of pain and

    responding to the other signs of pain. For those individuals living with dementia who cannot

    clearly verbalise their pain there is an ‘Gold Standard’ observational pain assessment tool

    known as the ‘Abbey Pain Scale’. The Abbey Pain Scale can be used to assess levels of pain

    and develop a pain management plan for individuals living with dementia. Despite the

    abundant evidence of the effectiveness of the Abbey Pain Scale for detecting and managing

    pain it remains largely unused in everyday clinical practice. The Aged and Dementia Care

    Health Research and Education (ADHERe) team at UOW wanted to address this gap and

    developed an Abbey Pain Scale filmed vignette educational resource. Three videos

    demonstrate a nurse practitioner providing education to a family carer and registered nurses

    in acute care and nursing home settings on how to use the Abbey Pain Scale.

    If a person with dementia experiences unexplained changes and/ or shows signs of distress,

    healthcare professionals should assess whether the person is in pain but without a tool like the

    Abbey Pain Scale this is difficult to do achieve. The Abbey Pain Scale filmed vignettes

    demonstrate how to assess pain experienced by individuals living with a dementia in their

    own home, in hospital and in a nursing home. The videos can be used to assist healthcare

    professionals learn how to better detect and manage pain experienced individuals living with

    dementia who cannot easily express their pain verbally.

Publication Date


  • 2018

Citation


  • Chang, H., David, V. A., Britten, N. & De Vries, L. (2018). Better equipping healthcare professionals in pain management of people with dementia. Australian Nursing and Midwifery Journal, 25 (7), 41-41.

Ro Metadata Url


  • http://ro.uow.edu.au/smhpapers/5259

Number Of Pages


  • 0

Start Page


  • 41

End Page


  • 41

Volume


  • 25

Issue


  • 7

Place Of Publication


  • Australia

Abstract


  • Pain management for individuals living with a dementia is one area of nursing care which

    needs improved. As a dementia progresses, verbal language skills can deteriorate and

    individuals rely more on non-verbal ways of communicating. It can become difficult, if not

    impossible, for individuals living with dementia to use words to explain their pain to

    someone else. Individuals living with a dementia then become at high risk of living with

    chronic pain. And, not unsurprisingly, this has a negative effect on their quality of life which

    in turn causes further deterioration of an individual’s dementia and high levels of stress for

    family and healthcare professionals providing care.

    It is estimated up to 80% of older people living in nursing homes experience chronic pain and

    in Australia more than half of these older people (52%) have a diagnosis of dementia while

    two in three (67%) require high-level care to manage distress situation (Gibson, 2007;

    Zwakhalen, 2006). We can therefore assume that a high proportion of people with chronic

    pain also have cognitive impairment and will have difficulties in verbally expressing their

    pain. The Australian Pain Society (2005) reported that individuals living with a dementia

    who experience pain have their pain left untreated at higher rates that those without dementia.

    In one study, pain was detected in just 31.5% of cognitively-impaired residents compared to

    61% of cognitively-intact residents, despite both groups being equally afflicted with

    potentially painful disease (Proctor & Hirdes, 2001).

    This situation can be avoided using close observation of non-verbal expressions of pain and

    responding to the other signs of pain. For those individuals living with dementia who cannot

    clearly verbalise their pain there is an ‘Gold Standard’ observational pain assessment tool

    known as the ‘Abbey Pain Scale’. The Abbey Pain Scale can be used to assess levels of pain

    and develop a pain management plan for individuals living with dementia. Despite the

    abundant evidence of the effectiveness of the Abbey Pain Scale for detecting and managing

    pain it remains largely unused in everyday clinical practice. The Aged and Dementia Care

    Health Research and Education (ADHERe) team at UOW wanted to address this gap and

    developed an Abbey Pain Scale filmed vignette educational resource. Three videos

    demonstrate a nurse practitioner providing education to a family carer and registered nurses

    in acute care and nursing home settings on how to use the Abbey Pain Scale.

    If a person with dementia experiences unexplained changes and/ or shows signs of distress,

    healthcare professionals should assess whether the person is in pain but without a tool like the

    Abbey Pain Scale this is difficult to do achieve. The Abbey Pain Scale filmed vignettes

    demonstrate how to assess pain experienced by individuals living with a dementia in their

    own home, in hospital and in a nursing home. The videos can be used to assist healthcare

    professionals learn how to better detect and manage pain experienced individuals living with

    dementia who cannot easily express their pain verbally.

Publication Date


  • 2018

Citation


  • Chang, H., David, V. A., Britten, N. & De Vries, L. (2018). Better equipping healthcare professionals in pain management of people with dementia. Australian Nursing and Midwifery Journal, 25 (7), 41-41.

Ro Metadata Url


  • http://ro.uow.edu.au/smhpapers/5259

Number Of Pages


  • 0

Start Page


  • 41

End Page


  • 41

Volume


  • 25

Issue


  • 7

Place Of Publication


  • Australia