Home' Australian Ageing Agenda : AAA Nov-Dec 2016 Contents They also assisted in overcoming
barriers including programming time
for staff to attend training, and ensuring
the project was rolled out in the given
timeframes, as well as assisting with
those services that needed help in
To ensure a prompt rollout, different
methods were used to engage with field
staff, including providing a whole day
of sessions, or separate topics, with
timeframes designed to fit in between
shifts and staff movements.
The first round of data from the program
and rollout of the new pain management
systems is being analysed now, and
we're looking forward to analysing the
results and reviewing both positive and
The initiative will be used to further
improve levels of compliance across the
organisation and ensure we continue to
maintain best practice guidelines in line
with the aged care sector.
The real boost should come from
increased accuracy in pain assessments,
an improved use of appropriate and
multimodal assessments, and most
importantly, our residents will be as pain
free as possible.
If we could give our fellow providers
one piece of advice, it's to engage with
key partners who are recognised experts
in the industry, to establish strong best
practice pain management outcomes for
residents in their care. n
Anne Maree Hodgson is general manager
of residential care at Catholic Healthcare.
Pain management in
aged care is challenging
and a number of barriers
have been identified.
Free pain resource for aged care
Despite numerous barriers, ongoing education is the best way to ensure aged care staff can
adequately identify and treat pain in people living with dementia and improve their outcomes.
That's according to clinical nurse consultant Bronwyn Arthur, who is one of four experts in
See Change. Think Pain. Pain management for people with dementia, a free 30-minute program
produced by the Aged Care Channel in association with the Australian Pain Society.
In her consultancy role in aged and extended care at NSW Health, Arthur works with a
multidisciplinary team in the management of behavioural and psychological symptoms of
dementia (BPSD) and delirium.
"All education is important and it is one of the most direct ways of improving patient and
resident outcomes," Arthur tells Australian Ageing Agenda.
To promote better awareness of care for people with dementia and the treatment of pain,
Arthur says aged care staff and clinicians should have "a high index of suspicion around
pain" when seeing changes in behaviours. She provides the following advice:
• do not be afraid to medicate for pain using appropriate doses and medications
• start low, and go slow
• be aware of poly-pharmacy, drug interactions with the various pain medications and
side effects of medications versus allergic reactions, and then educate the person with
dementia and families
• use validated tools like the ABBEY Pain Scale, the PAINAD, the Modified Resident's Brief
Pain Inventory, or the Brief Pain Inventory to assess for pain
• document observations well and descriptively so that anyone reading the notes can
actually vividly imagine what the person documenting saw
• develop a non-pharmacological toolkit with a variety of strategies to distract when BPSD
is at its worst, such as when "sundowning"
• keep families and carers informed of what is happening, educate where possible to
maintain integrity and transparency of care plans and management strategies, and get
them involved in care strategies where appropriate and relevant
• keep up to date with new practice
The program See Change. Think Pain. Pain management for people with dementia
features a 20-minute presentation followed by a 10-minute discussion by a panel of experts.
Along with Arthur, panellists include consultant geriatrician and pain specialist Associate
Professor Benny Katz, Dr Steve Macfarlane, an Associate Professor of Aged Psychiatry, and
GP Dr Peter Piazza.
The program identifies barriers to pain management and explains how to assess and
manage pain for people with dementia and is suitable for registered nurses, enrolled nurses,
assistants in nursing, and professional aged care staff.
Go to acctv.co/thinkpain/
www.australianageingagenda.com.au | 51
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