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.

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.

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

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 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 An Empirical Study on Tele-Consultation In Home-Visit Nursing Care Setting Under Korean Long-Term Care Insurance System

2021 ◽  
Vol 23 (3) ◽  
pp. 249-260
Author(s):  
Jungsuk Lee ◽  
Hee Seung Lee ◽  
Yeongwoo Park ◽  
Rahil Hwang
Keyword(s):  
Home Care ◽  
Nursing Care ◽  
Home Visit ◽  
Care Setting ◽  
Long Term Care ◽  
Service Providers ◽  
Pilot Project ◽  
Care Quality ◽  
Term Care

Purpose: The National Health Insurance Service implemented a tele-consultation pilot project for in-home care using Information and Communication Technologies (ICTs). This study aims to investigate nurses’, doctors’, and families’ perceptions on the project.Methods: Using the pilot project database and perception survey data, this study provides a description of the satisfaction, re-participation motivation, and experiences of nurses, doctors, and families.Results: Tele-consultation for home-visit nursing was used to monitor health conditions and problems, such as pain and blood pressure, or health counseling for home-care beneficiaries. The beneficiaries' families showed higher levels of satisfaction than the service providers. Nurses and doctors had relatively positive perceptions about the usefulness of sharing information about beneficiaries, timeliness of providing nursing care, and convenience of communication. Meanwhile, nurses and doctors had negative perceptions of the sufficiency and accuracy of information obtained from tele-consultation, implying the necessity of adopting more advanced ICTs.Conclusion: This study suggests what must be considered when designing a tele-consultation service model in long-term care settings, especially in the home-visit nursing care setting. Innovative approaches using ICTs should be taken to improve home-visit nursing care quality in the era of super-aging and COVID-19.

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