scholarly journals A retrospective review of pain management in Tasmanian residential aged care facilities

BJGP Open ◽  
2019 ◽  
Vol 3 (1) ◽  
pp. bjgpopen18X101629 ◽  
Author(s):  
Felicity Veal ◽  
Mackenzie Williams ◽  
Luke Bereznicki ◽  
Elizabeth Cummings ◽  
Tania Winzenberg
Keyword(s):  
Pain Assessment ◽  
Retrospective Review ◽  
Univariate Analysis ◽  
Final Analysis ◽  
Aged Care ◽  
Residential Aged Care ◽  
Medication History ◽  
Care Facilities ◽  
Aged Care Facilities ◽  
Residential Aged Care Facilities

BackgroundThe management of pain by GPs for residents of aged care facilities (ACFs) is very common.AimTo measure the prevalence and assess the management of pain in ACF residents, particularly those with dementia.Design & settingA retrospective review of ACF residents’ medical records was undertaken at five southern Tasmanian (Australia) ACFs.MethodData extracted included results of the most recent assessment of pain and its management, frequency and treatment of pain incidents in the previous 7 days, demographics, and medical and medication history. Univariate analysis was used to identify variables associated with increased frequency of pain episodes.ResultsThe final analysis included 477 residents. At least one episode of pain in the preceding 7 days was documented in 25.6% (n = 122) of residents' notes. Pain episodes were most commonly managed by analgesics (45.5%), massage (40.7%), and heatpacks (13.8%). Residents with dementia were not less likely to have pain identified during the past week (14% versus 20%; P = 0.09), but they were much less likely to have pain identified on their most recent pain assessment (P = 0.03).ConclusionGPs should carefully consider the suitability of using ‘as required’ analgesics. Furthermore, on admission to an ACF, GPs need to ensure a patient’s medical history includes all pain or potentially pain-causing conditions, to ensure that a resident’s pain assessment is complete. This is especially necessary for those with dementia, to ensure that staff remain vigilant about the possibility of the resident experiencing pain.

scholarly journals Pain Assessment in Older Adults with Dementia: An Exploratory Pilot Study of Paramedic Students' Perceptions of the Utility of Two Validated Assessment Tools

2016 ◽  
Vol 13 (3) ◽  
Author(s):  
Peter Vincent Lucas ◽  
Ron Mason ◽  
Michael Annear ◽  
Wayne Harris ◽  
Michael McCall ◽  
...  
Keyword(s):  
Pain Assessment ◽  
Learning Experience ◽  
Aged Care ◽  
Pain Scale ◽  
Assessment Tools ◽  
Residential Aged Care ◽  
Community Settings ◽  
Care Facilities ◽  
Aged Care Facilities ◽  
Residential Aged Care Facilities

Abstract IntroductionThis paper presents findings from an exploratory study in which undergraduate paramedic students’ trialled the use of two pain assessment tools as part of an interprofessional learning experience in residential aged care facilities. The research sought to identify the potential utility of the Abbey Pain Scale and PAINAD tools for use by paramedics with people with advanced dementia who have limited ability to communicate.MethodsThirty-one final year undergraduate paramedic students completed a 5-day clinical placement in in four residential aged care facilities in Tasmania, Australia. While on placement students used the two tools to assess pain in residents with known pain issues, under the supervision of nursing staff and paramedic tutors. A mixed methods approach, utilising a quantitative survey and a qualitative open-ended questionnaire, was adopted to ascertain students’ views on the potential for the tools to be used in paramedic practice.ResultsThe research found both tools had potential for use in paramedic practice. Feedback from students indicated both pain assessment tools had strengths and weaknesses. Recommendations were made for how each of the tools could be adapted to make them suitable for use by paramedics.ConclusionForecast increases in the number of people living with dementia, and the changing nature of paramedic practice, means that paramedics are more likely to be called on to assess pain in this population in community settings. Further research is needed to inform the development of pain assessment tools specifically for use by paramedics in these settings.

Dementia in Aboriginal people in Residential Aged Care Facilities in Alice Springs: A Descriptive Study

2019 ◽  
Vol 20 (2) ◽  
pp. 171-179
Author(s):  
Bruce Hocking ◽  
Michael Lowe ◽  
Tricia Nagel ◽  
Caroline Phillips ◽  
Melissa Lindeman ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Assessment ◽  
Aboriginal People ◽  
Aged Care ◽  
Residential Aged Care ◽  
Aboriginal Populations ◽  
Care Facilities ◽  
Aged Care Facilities ◽  
Residential Aged Care Facilities ◽  
Clinical File

AbstractBackground:A high prevalence of dementia among Aboriginal and Torres Strait Islanders has been reported but knowledge of underlying causes and associations remains limited.Objective:To identify the prevalence of factors that may be associated with the categories of Major neurocognitive disorders (Major NCDs) in Aboriginal people living in residential aged care facilities in Alice Springs in the Northern Territory (NT).Design and Setting:This descriptive cross-sectional study analysed clinical file and cognitive assessment data of participants who were identified as having cognitive impairment between January and June 2016.Method:Screening for the presence of cognitive impairment using the Kimberley Indigenous Cognitive Assessment (KICA) was undertaken and 58 of 84 Aboriginal people were admitted to the study. Using a clinical file audit, diagnoses of Major NCDs consistent with the DSM-5 classification were made and the prevalence of factors possibly associated with these diagnoses described.Results:Fifty of the 58 participants were diagnosed with a Major NCD. The most frequent diagnoses were Major NCD due to vascular disease (30%), Major NCD due to Alzheimer’s Disease (26%) and Major NCD due to brain injury (20%). Hypertension, Type 2 Diabetes Mellitus and alcohol misuse were commonly reported together with hypothyroidism, hypoglycaemia and vitamin D deficiency.Conclusion(s):This study identified possible associations with Major NCDs in this population as well as a different spread of Major NCD diagnoses to previous studies in Aboriginal populations. There is a need for further research to understand the causes of dementia in Australian Aboriginal people and to use this information to appropriately tailor treatment and prevention programmes.

Enhancing palliative care in rural Australia: the residential aged care setting

2011 ◽  
Vol 17 (1) ◽  
pp. 95 ◽  
Author(s):  
Geoffrey Mitchell ◽  
Caroline Nicholson ◽  
Keith McDonald ◽  
Anne Bucetti
Keyword(s):  
Palliative Care ◽  
End Of Life Care ◽  
Aged Care ◽  
Care Staff ◽  
Residential Aged Care ◽  
Care Facilities ◽  
Aged Care Facilities ◽  
Residential Aged Care Facilities ◽  
Advance Care

The delivery of palliative care in residential aged care communities is challenging, even more so in rural areas due to workforce ageing and shortages. The objectives of the present study were to: (i) assess the needs of, and quality of palliative care delivered to residents of 16 residential aged care facilities in rural southern Australia; and (ii) identify the needs of care staff to facilitate the delivery of quality palliative care. A cross-sectional survey of all residents, assessing the degree of functional limitation, stage of palliative care, and the presence of several quality indicators was conducted. Separate focus groups of care staff and relatives of residents sought information on the quality of care delivered, perceived strengths and weaknesses of the care delivered, and education and training needs. Quality palliative care in residential aged care facilities (RACFs) is hampered by workforce shortages, with low ratios of registered nurses, limited access to general practitioners after hours, and some communication difficulties. Some staff reported low confidence in technical and psychosocial aspects of care, especially for relatives. Relatives described mostly appropriate care, while acknowledging workload constraints. Most residents whose condition was unstable, deteriorating or terminal received advance care planning, though family expectations and unwillingness to discuss end-of-life care did tend to delay planning. Unstable residents with a reasonable prognosis were more likely to be transferred to hospital than terminally ill residents. Palliative care in participating RACFs appears to be adequate. Provision of targeted education for health care providers and implementation of protocols for advance care planning and end-of life care pathways will enhance this care.

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