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.

scholarly journals Quality use of antipsychotic medicines inresidential aged care facilities in New Zealand

2016 ◽  
Vol 8 (4) ◽  
pp. 335 ◽  
Author(s):  
Henry C. Ndukwe ◽  
Prasad S. Nishtala ◽  
Ting Wang ◽  
June M. Tordoff
Keyword(s):  
New Zealand ◽  
Adverse Effects ◽  
Nurse Managers ◽  
Aged Care ◽  
Assessment Tools ◽  
Residential Aged Care ◽  
Staff Education ◽  
Care Facilities ◽  
Aged Care Facilities ◽  
Residential Aged Care Facilities

ABSTRACT INTRODUCTION Antipsychotic medicines are used regularly or when required in residential aged care facilities to treat symptoms of dementia, but have been associated with several adverse effects. AIM The aim of this study was to examine ‘quality use’ of antipsychotic medicines in residential aged care facilities in New Zealand, by surveying nurse managers. METHODS A cross-sectional survey was mailed to 318 nurse managers working in a nationally representative sample of aged care facilities. A purpose-developed, pre-tested, 22-item structured questionnaire was used to explore practice related to the quality use of antipsychotic medicines. RESULTS Overall, 31.4% of nurse managers responded to the survey. They mostly (88%) had ≥ 1 year’s relevant work experience and 83% of facilities provided care for those within the range of 21 to 100 residents. Respondents reported that staff education on dementia management occurred early in employment. Two-thirds of participants reported non-pharmacological interventions were commonly used for managing challenging behaviours, while less than half (45%) cited administering antipsychotic medicine. Respondents reported ‘managing behavioural symptoms’ (81%) as one of the main indications for antipsychotic use. Frequently identified adverse effects of antipsychotic medicines were drowsiness or sedation (64%) and falls (61%). Over 90% reported general practitioners reviewed antipsychotic use with respect to residents’ target behaviour 3-monthly, and two-thirds used an assessment tool to appraise residents’ behaviour. DISCUSSION Staff education on dementia management soon after employment and resident 3-monthly antipsychotic medicine reviews were positive findings. However, a wider use of behavioural assessment tools might improve the care of residents with dementia and the quality use of antipsychotic medicines.

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.

Investigating the current methods of assessing behavioral and psychological symptoms in residential aged care facilities in a metropolitan city

2016 ◽  
Vol 29 (5) ◽  
pp. 855-858 ◽  
Author(s):  
Samantha M. Loi ◽  
Nicola T. Lautenschlager
Keyword(s):  
Psychological Symptoms ◽  
Aged Care ◽  
Assessment Tools ◽  
Residential Aged Care ◽  
Convenience Sample ◽  
Major Barrier ◽  
Care Facilities ◽  
Aged Care Facilities ◽  
Residential Aged Care Facilities ◽  
Behavioral And Psychological Symptoms

ABSTRACTUp to 90% of people with dementia living in residential aged care facilities (RACFs) display behavioral and psychological symptoms of dementia (BPSD), and these are associated with poorer quality of life and increased morbidity and mortality. In order to implement appropriate interventions, it is important to understand the symptoms in more detail. Despite the availability of BPSD assessment tools, it is unknown what the current practice of monitoring of BPSD in RACFs. We sought to investigate the current BPSD assessment tools being used in RACFs and explore different stakeholders’ views on current practices. A cross-sectional convenience sample of 21 clinicians were identified and administered a questionnaire.Old age psychiatrists, aged psychiatry clinicians, behavior management teams and RACF staff completed the questionnaires. Clinicians reported that objective consistent information about BPSD were important for recommending and implementing pharmacological and non-pharmacological strategies for BPSD; however, the use of validated BPSD assessments in RACFs was not a usual part of clinical practice. RACF staff stated the major barrier to assessment of BPSD was lack of time. Alternate methods of assessing BPSD which consider preferences from clinicians and RACF staff should be further investigated. Modern technology which can allow “real time” assessment may be a solution.

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.

Sign in / Sign up

Export Citation Format

Share Document