It’s the final day of Moorfields’s dementia awareness week, and we are closing our campaign by focussing on pain management. The Behaviour and Pain 2013 (BePaid) study showed that pain is common in patients with dementia, and further research has shown that patients with dementia in hospital were 50% less likely to receive analgesia than patients without dementia. The Bepaid study also showed that: •28% of patients had pain at rest and 65% had pain on movement at some time during their admission •A further study has shown that ‘pain was strongly and consistently associated with extreme behaviour, particularly aggression and anxiety’ •Pain can be from the presenting condition or from pre-existing conditions. Why is pain not always recognised in people with dementia? •The person with dementia may not have the ability to verbally communicate what they are feeling •The person with dementia may not be able to remember pain they experienced earlier •The person with dementia may not be able to identify where their pain is located What observable indicators suggest a person with dementia is in pain? •Autonomic changes •Bodily indications •Vocalisations •Facial expressions •Interpersonal reactions •Changes in activity patterns •Cognitive/emotional changes Individual responses How to assess pain in a person with dementia: •Does the patient have a painful condition? (would it hurt you?) •Does the patient look as if he/she is in pain? •Observational Pain assessment tool (e.g. Abbey or Painad) – if required •Information from relatives and carers (individual pain indicators) How can pain be best managed? •Appropriate, regular analgesia (including anticipatory analgesia if a patient requires examination) administered through the most suitable method •Reduce isolation and anxiety by providing reassurance, communication, empathy and kindness •Carry out procedures in a way that avoids or minimises triggering pain •Provide distraction by helping the person become occupied For more information about pain in dementia please click here. Local services and key contacts for people with dementia Moorfields: Trust dementia lead: Tracy Luckett, director of nursing and allied health professions Lead contact for dementia training: Carmel Brookes, lead nurse for clinical innovation and safety and Tim Withers, practice educator Relevant services for people with dementia within the Moorfields: Every clinical area has a nominated dementia link nurse who can signpost you to further resources. Safeguarding lead: Carmel Brookes, lead nurse for clinical innovation and safety Our local contacts: Local memory service: For further details, please click the link https://myhealth.london.nhs.uk/health-communities/dementia/getting-started/memory-services Social Services: Please look on the Local Authority Borough website for your area. National helplines: Admiral Nursing DIRECT, Dementia UK - 0845 257 9406 This is a national helpline and email service, provided by experienced Admiral Nurses for family and professional carers, people with dementia and those worried about their memory. It gives practical advice and emotional support to anyone affected by dementia. Alzheimers Society National Dementia Helpline - 0300 222 1122 Can provide information, support, guidance and signposting to other appropriate organisations. Further dementia training For any staff whose work brings them into regular contact with people with dementia, it is essential to be fully equipped for your role. Various courses and opportunities are available for you to undertake further dementia training within your hospital. Please contact practice development on x2650 if you are interested in undertaking further training or go to the online training resource below scie.org.uk/publications/elearning/dementia/index.asp
Posted on: Fri, 24 Jan 2014 15:49:09 +0000
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