Silent and suffering: a pilot study exploring gaps between theory and practice in pain management for people with severe dementia in residential aged care facilities

Carmelle Peisah,1–3 Judith Weaver,1 Lisa Wong,1 Julie-Anne Strukovski1 1Behaviour Assessment Management Service, Specialist Mental Health Services for Older People, Mental Health Drug and Alcohol, Northern Sydney Local Health District, 2University of Sydney, 3University of NSW, Sydney, NS...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Peisah C, Weaver J, Wong L, Strukovski JA
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2014
Materias:	pain dementia severe residential care facilities Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/48fcb5ad110c44fe8e1dafe896b6f744
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:48fcb5ad110c44fe8e1dafe896b6f744
record_format	dspace
spelling	oai:doaj.org-article:48fcb5ad110c44fe8e1dafe896b6f7442021-12-02T00:54:28ZSilent and suffering: a pilot study exploring gaps between theory and practice in pain management for people with severe dementia in residential aged care facilities1178-1998https://doaj.org/article/48fcb5ad110c44fe8e1dafe896b6f7442014-10-01T00:00:00Zhttps://www.dovepress.com/silent-and-suffering-a-pilot-study-exploring-gaps-between-theory-and-p-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Carmelle Peisah,1–3 Judith Weaver,1 Lisa Wong,1 Julie-Anne Strukovski1 1Behaviour Assessment Management Service, Specialist Mental Health Services for Older People, Mental Health Drug and Alcohol, Northern Sydney Local Health District, 2University of Sydney, 3University of NSW, Sydney, NSW, Australia Background: Pain is common in older people, particularly those in residential aged care facilities (RACF) and those with dementia. However, despite 20 years of discourse on pain and dementia, pain is still undetected or misinterpreted in people with dementia in residential aged care facilities, particularly those with communication difficulties. Methods: A topical survey typology with semistructured interviews was used to gather attitudes and experiences of staff from 15 RACF across Northern Sydney Local Health District. Results: While pain is proactively assessed and pain charts are used in RACF, this is more often regulatory-driven than patient-driven (eg, prior to accreditation). Identification of pain and need for pain relief was ill defined and poorly understood. Both pharmacological and nonpharmacological regimes were used, but in an ad hoc, variable and unsystematic manner, with patient, staff, and attitudinal obstacles between the experience of pain and its relief.Conclusion: A laborious “pain communication chain” exists between the experience of pain and its relief for people with severe dementia within RACF. Given the salience of pain for older people with dementia, we recommend early, proactive consideration and management of pain in the approach to behaviors of concern. Individualized pain measures for such residents; empowerment of nursing staff as “needs interpreters”; collaborative partnerships with common care goals between patients where possible; RACF staff, doctors, and family carers; and more meaningful use of pain charts to map response to stepped pain protocols may be useful strategies to explore in clinical settings. Keywords: pain, dementia, severe, residential aged care, facilitiesPeisah CWeaver JWong LStrukovski JADove Medical Pressarticlepaindementiasevereresidential care facilitiesGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 9, Pp 1767-1774 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	pain dementia severe residential care facilities Geriatrics RC952-954.6
spellingShingle	pain dementia severe residential care facilities Geriatrics RC952-954.6 Peisah C Weaver J Wong L Strukovski JA Silent and suffering: a pilot study exploring gaps between theory and practice in pain management for people with severe dementia in residential aged care facilities
description	Carmelle Peisah,1–3 Judith Weaver,1 Lisa Wong,1 Julie-Anne Strukovski1 1Behaviour Assessment Management Service, Specialist Mental Health Services for Older People, Mental Health Drug and Alcohol, Northern Sydney Local Health District, 2University of Sydney, 3University of NSW, Sydney, NSW, Australia Background: Pain is common in older people, particularly those in residential aged care facilities (RACF) and those with dementia. However, despite 20 years of discourse on pain and dementia, pain is still undetected or misinterpreted in people with dementia in residential aged care facilities, particularly those with communication difficulties. Methods: A topical survey typology with semistructured interviews was used to gather attitudes and experiences of staff from 15 RACF across Northern Sydney Local Health District. Results: While pain is proactively assessed and pain charts are used in RACF, this is more often regulatory-driven than patient-driven (eg, prior to accreditation). Identification of pain and need for pain relief was ill defined and poorly understood. Both pharmacological and nonpharmacological regimes were used, but in an ad hoc, variable and unsystematic manner, with patient, staff, and attitudinal obstacles between the experience of pain and its relief.Conclusion: A laborious “pain communication chain” exists between the experience of pain and its relief for people with severe dementia within RACF. Given the salience of pain for older people with dementia, we recommend early, proactive consideration and management of pain in the approach to behaviors of concern. Individualized pain measures for such residents; empowerment of nursing staff as “needs interpreters”; collaborative partnerships with common care goals between patients where possible; RACF staff, doctors, and family carers; and more meaningful use of pain charts to map response to stepped pain protocols may be useful strategies to explore in clinical settings. Keywords: pain, dementia, severe, residential aged care, facilities
format	article
author	Peisah C Weaver J Wong L Strukovski JA
author_facet	Peisah C Weaver J Wong L Strukovski JA
author_sort	Peisah C
title	Silent and suffering: a pilot study exploring gaps between theory and practice in pain management for people with severe dementia in residential aged care facilities
title_short	Silent and suffering: a pilot study exploring gaps between theory and practice in pain management for people with severe dementia in residential aged care facilities
title_full	Silent and suffering: a pilot study exploring gaps between theory and practice in pain management for people with severe dementia in residential aged care facilities
title_fullStr	Silent and suffering: a pilot study exploring gaps between theory and practice in pain management for people with severe dementia in residential aged care facilities
title_full_unstemmed	Silent and suffering: a pilot study exploring gaps between theory and practice in pain management for people with severe dementia in residential aged care facilities
title_sort	silent and suffering: a pilot study exploring gaps between theory and practice in pain management for people with severe dementia in residential aged care facilities
publisher	Dove Medical Press
publishDate	2014
url	https://doaj.org/article/48fcb5ad110c44fe8e1dafe896b6f744
work_keys_str_mv	AT peisahc silentandsufferingapilotstudyexploringgapsbetweentheoryandpracticeinpainmanagementforpeoplewithseveredementiainresidentialagedcarefacilities AT weaverj silentandsufferingapilotstudyexploringgapsbetweentheoryandpracticeinpainmanagementforpeoplewithseveredementiainresidentialagedcarefacilities AT wongl silentandsufferingapilotstudyexploringgapsbetweentheoryandpracticeinpainmanagementforpeoplewithseveredementiainresidentialagedcarefacilities AT strukovskija silentandsufferingapilotstudyexploringgapsbetweentheoryandpracticeinpainmanagementforpeoplewithseveredementiainresidentialagedcarefacilities
_version_	1718403435289640960

Silent and suffering: a pilot study exploring gaps between theory and practice in pain management for people with severe dementia in residential aged care facilities

Ejemplares similares