A Comparison Between Behavioral and Verbal Report Pain Assessment Tools for Use with Residents in Long Term Care

2013 ◽  
Vol 14 (4) ◽  
pp. e106-e114 ◽  
Author(s):  
Sharon Kaasalainen ◽  
Noori Akhtar-Danesh ◽  
Thomas Hadjistavropoulos ◽  
Sandra Zwakhalen ◽  
Rene Verreault
Keyword(s):  
Pain Assessment ◽  
Long Term Care ◽  
Verbal Report ◽  
Assessment Tools ◽  
Term Care

scholarly journals Provincial legislative and regulatory standards for pain assessment and management in long-term care homes: a scoping review and in-depth case analysis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Natasha L. Gallant ◽  
Allie Peckham ◽  
Gregory Marchildon ◽  
Thomas Hadjistavropoulos ◽  
Blair Roblin ◽  
...  
Keyword(s):  
Scoping Review ◽  
Pain Assessment ◽  
Clinical Guidelines ◽  
Long Term Care ◽  
Case Analysis ◽  
Assessment Tools ◽  
Evidence Based ◽  
Term Care ◽  
Limited Ability

Abstract Background Among Canadian residents living in long-term care (LTC) facilities, and especially among those with limited ability to communicate due to dementia, pain remains underassessed and undermanaged. Although evidence-based clinical guidelines for the assessment and management of pain exist, these clinical guidelines are not widely implemented in LTC facilities. A relatively unexplored avenue for change is the influence that statutes and regulations could exert on pain practices within LTC. This review is therefore aimed at identifying the current landscape of policy levers used across Canada to assess and manage pain among LTC residents and to evaluate the extent to which they are concordant with evidence-based clinical guidelines proposed by an international consensus group consisting of both geriatric pain and public policy experts. Methods Using scoping review methodology, a search for peer-reviewed journal articles and government documents pertaining to pain in Canadian LTC facilities was carried out. This scoping review was complemented by an in-depth case analysis of Alberta, Saskatchewan, and Ontario statutes and regulations. Results Across provinces, pain was highly prevalent and was associated with adverse consequences among LTC residents. The considerable benefits of using a standardized pain assessment protocol, along with the barriers in implementing such a protocol, were identified. For most provinces, pain assessment and management in LTC residents was not specifically addressed in their statutes or regulations. In Alberta, Saskatchewan, and Ontario, regulations mandate the use of the interRAI suite of assessment tools for the assessment and reporting of pain. Conclusion The prevalence of pain and the benefits of implementing standardized pain assessment protocols has been reported in the research literature. Despite occasional references to pain, however, existing regulations do not recommend assessments of pain at the frequency specified by experts. Insufficient direction on the use of specialized pain assessment tools (especially in the case of those with limited ability to communicate) that minimize reliance on subjective judgements was also identified in current regulations. Existing policies therefore fail to adequately address the underassessment and undermanagement of pain in older adults residing in LTC facilities in ways that are aligned with expert consensus.

scholarly journals Barriers and Facilitators of Pain Management in Persons With Dementia in Long-Term Care: A Scoping Review

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 166-166
Author(s):  
Yo-Jen Liao ◽  
Ying-Ling Jao ◽  
Diane Berish ◽  
Lisa Kitko
Keyword(s):  
Pain Management ◽  
Pain Assessment ◽  
Long Term Care ◽  
Care Quality ◽  
Assessment Tools ◽  
Barriers And Facilitators ◽  
Current Evidence ◽  
Original Research ◽  
Term Care

Abstract Approximately 50% of individuals with dementia regularly experience moderate to severe pain, which is largely undermanaged. Several studies have explored the barriers and facilitators of pain management for persons with dementia; yet the evidence has not been systematically reviewed. This review aimed to synthesize current evidence on the barriers and facilitators of pain management in persons with dementia in long-term care. A PRISMA guided literature search was conducted in PubMed, CINAHL, and PsycINFO. Titles, abstracts, and full texts were screened. Included articles were original research examining the barriers or facilitators of pain assessment and treatment in individuals with dementia in long-term care. Quality assessment was conducted using the Risk of Bias tool and Johns Hopkins Level of Evidence. Ten studies were identified, including four quantitative studies, five qualitative studies, and one with both quantitative and qualitative research. Barriers of pain management identified include residents’ ability to self-report pain, pain medication side effects, need discrepancy among residents and their families, reluctance in administering analgesics, lack of pain assessment tools, lack of guidance in providing nonpharmacological interventions, and lack of clinical guidelines. Facilitators of pain management include clinicians with caring and enthusiastic characteristics, clinicians’ knowledge of residents, positive relationships among clinicians, good communication skills, using validated pain assessment tools, understanding pain indicators, clinical experience, and need-driven continuing education. These results can guide clinical practice in long-term care. Interventions should be developed to target these barriers and facilitators and improve pain management in persons with dementia.

Pain assessment tools for older adults with dementia in long-term care facilities: a systematic review

2016 ◽  
Vol 6 (6) ◽  
pp. 525-538 ◽  
Author(s):  
Selina Chow ◽  
Ronald Chow ◽  
Michael Lam ◽  
Leigha Rowbottom ◽  
Drew Hollenberg ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Pain Assessment ◽  
Long Term Care ◽  
Assessment Tools ◽  
Term Care ◽  
Care Facilities

scholarly journals Issues Related to Late-Life Sexuality: Sex in Long-Term Care

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 602-602
Author(s):  
Rachael Spalding ◽  
Peter Lichtenberg
Keyword(s):  
Best Practice ◽  
Long Term Care ◽  
Social Stigma ◽  
Late Life ◽  
Assessment Tools ◽  
Geographical Differences ◽  
Term Care ◽  
Practical Applications ◽  
Ethical And Legal Issues

Abstract Despite surrounding social stigma and stereotypes of the “asexual older adult,” older adults, including those residing in long-term care facilities, indicate that expressing their sexuality continues to be important to them (Doll, 2013). This presentation will feature presentations regarding recent research and perspectives relevant to late-life sexuality with a focus on how issues of sexual expression may particularly emerge in long-term care settings. Dr. Maggie Syme will present findings from mixed-methods, consumer-based approaches that elucidate how current and future long-term care residents view late-life sexuality, with a focus on the practical applications of these findings to inform facility administration and policies. Ethical and legal issues surrounding sexuality in long-term care will be discussed by Dr. Pamela Teaster, who will present ethical models that can translate into potential best-practice recommendations and strategies. Rachael Spalding will discuss the paucity of psychometrically sound assessment tools for measuring attitudes towards late-life sexuality and discuss their development of such a measure. Finally, Dr. Lilanta Bradley and Dr. Pamela Payne-Foster will present a framework for sexual agency in late-life and identify relevant gaps in the literature regarding gender, ethnicity/race, and geographical differences. Ultimately, this presentation will offer a forum for lively discussion among attendees regarding these pertinent topics.

scholarly journals Mapping Research Conducted on Long-Term Care Facilities for Older People in Brazil: A Scoping Review

2021 ◽  
Vol 18 (4) ◽  
pp. 1522
Author(s):  
Patrick Alexander Wachholz ◽  
Deborah Cristina De Oliveira ◽  
Kathryn Hinsliff-Smith ◽  
Reena Devi ◽  
Paulo José Fortes Villas Boas ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Older People ◽  
Study Design ◽  
Scoping Review ◽  
Long Term Care ◽  
Assessment Tools ◽  
Small Scale ◽  
Term Care ◽  
Care Facilities

This scoping review aimed to explore the characteristics, strengths, and gaps in research conducted in Brazilian long-term care facilities (LTCFs) for older adults. Electronic searches investigating the residents (≥60 years old), their families, and the LTCF workforce in Brazil were conducted in Medline, EMBASE, LILACS, and Google Scholar, within the timescale of 1999 to 2018, limited to English, Portuguese, or Spanish. The reference lists were hand searched for additional papers. The Mixed Methods Appraisal Tool (MMAT) was used for critical appraisal of evidence. Data were reported descriptively considering the study design, using content analysis: 327 studies were included (n = 159 quantitative non-randomized, n = 82 quantitative descriptive, n = 67 qualitative, n = 11 mixed methods, n = 6 randomized controlled trials, and n = 2 translation of assessment tools). Regardless of the study design, most were conducted in a single LTCF (45.8%), in urban locations (84.3%), and in non-profit settings (38.7%). The randomized trials and descriptive studies presented the lowest methodological quality based on the MMAT. This is the first review to provide an overview of research on LTCFs for older people in Brazil. It illustrates an excess of small-scale, predominantly qualitative papers, many of which are reported in ways that do not allow the quality of the work to be assured.

scholarly journals Barriers and facilitators to optimal supportive end-of-life palliative care in long-term care facilities: a qualitative descriptive study of community-based and specialist palliative care physicians’ experiences, perceptions and perspectives

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e037466
Author(s):  
Patricia Harasym ◽  
Sarah Brisbin ◽  
Misha Afzaal ◽  
Aynharan Sinnarajah ◽  
Lorraine Venturato ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Long Term Care ◽  
Symptom Assessment ◽  
Assessment Tools ◽  
Life Care ◽  
Community Based ◽  
Term Care

ObjectiveThe COVID-19 pandemic has highlighted ongoing challenges to optimal supportive end-of-life care for adults living in long-term care (LTC) facilities. A supportive end-of-life care approach emphasises family involvement, optimal symptom control, multidisciplinary team collaboration and death and bereavement support services for residents and families. Community-based and palliative care specialist physicians who visit residents in LTC facilities play an important role in supportive end-of-life care. Yet, perspectives, experiences and perceptions of these physicians remain unknown. The objective of this study was to explore barriers and facilitators to optimal supportive end-of-life palliative care in LTC through the experiences and perceptions of community-based and palliative specialist physicians who visit LTC facilities.DesignQualitative study using semi-structured interviews, basic qualitative description and directed content analysis using the COM-B (capability, opportunity, motivation - behaviour) theoretical framework.SettingResidential long-term care.Participants23 physicians who visit LTC facilities from across Alberta, Canada, including both in urban and rural settings of whom 18 were community-based physicians and 5 were specialist palliative care physicians.ResultsMotivation barriers include families’ lack of frailty knowledge, unrealistic expectations and emotional reactions to grief and uncertainty. Capability barriers include lack of symptom assessment tools, as well as palliative care knowledge, training and mentorship. Physical and social design barriers include lack of dedicated spaces for death and bereavement, inadequate staff, and mental health and spiritual services of insufficient scope for the population.ConclusionFindings reveal that validating families’ concerns, having appropriate symptom assessment tools, providing mentorship in palliative care and adapting the physical and social environment to support dying and grieving with dignity facilitates supportive, end-of-life care within LTC.

scholarly journals Development and Mixed-Methods Evaluation of a Pain Assessment Video Training Program for Long-Term Care Staff

2013 ◽  
Vol 18 (6) ◽  
pp. 307-312 ◽  
Author(s):  
Michelle M Gagnon ◽  
Thomas Hadjistavropoulos ◽  
Jaime Williams
Keyword(s):  
Focus Groups ◽  
Pain Assessment ◽  
Long Term Care ◽  
Care Staff ◽  
Term Care ◽  
Pain Education ◽  
Video Training ◽  
Training Video

INTRODUCTION: Inadequacies in pain assessment and management in long-term care have been well documented. Insufficient pain education and inaccurate beliefs about the nature of pain and aging have been identified as possible contributors. The present study addresses the need for improved, efficient and feasible continuing pain education through the use of an assessment training video.METHODS: A total of 148 long-term care staff viewed and evaluated the training video. Knowledge changes and pain beliefs were assessed postvideo and at a four-week follow-up. Beliefs about pain, as well as pain and aging, were also examined using multivariate procedures to determine whether these variables influenced participants’ evaluation of the video. Focus groups were also conducted, and transcripts were analyzed using thematic content analysis.RESULTS: Pain assessment knowledge improved postvideo and at the four-week follow-up. Participants positively evaluated the content and quality of the video. Individuals who held stronger beliefs (at baseline) about the organic nature of pain provided more positive evaluations. Barriers to implementation of practices in the video identified by the focus groups (and qualitative analysis) included time, workload and resistance to change. Facilitators to implementation included continued management support and observing the benefits to implementation.DISCUSSION: The present study provides support for the use of video training. However, based on the focus group results, top-down implementation approaches with ongoing management involvement throughout the implementation process may be needed to achieve sustained changes in pain assessment practices. A model useful for sustained implementation was proposed and discussed, and is hoped to facilitate future research.

Behaviour assessment tools in long-term care homes in Canada: a survey

2020 ◽  
pp. 1-12
Author(s):  
Marion Penko ◽  
Hannah Quirt ◽  
Lori Schindel Martin ◽  
Andrea Iaboni
Keyword(s):  
Long Term Care ◽  
Assessment Tools ◽  
Care Homes ◽  
Term Care
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