Dementia care
during pain (simulated) and facial images show people in pain and clinical cases. A clinical facilitator experienced on the use of the system is responsible for running the training program. For each patient, it is essential that pain
assessments are first carried out during rest. This is in order to determine baseline scores for benchmarking purposes, and is followed by post-movement assessment to capture the nociceptive experience. Kinaesthetic activities such as bending and walking are part of daily living, and involve joint activity, which generates nociceptive signals, encoding the sensory aspect of pain phenomenon.1
Rise of AI in healthcare Utilising technology is an enabler. Tools that increase accuracy of assessments and reduce the time to eectively evaluate pain are crucial. Technology that overcomes the gap in pain documentation equips care providers with the means to better plan and treat pain according to evidence-based pain management practices, which ultimately, improves the quality of care. The opportunities AI offers to the
global healthcare sectors, from hospitals and primary care, to aged care facilities and home care, are vast. AI can be used to automate patient assessment and remove assessor bias. It can evaluate patient risk, such as of a
patient developing a particular disease or suffering a particular adverse event, diagnose disease, for example, by interpreting ECG results and X-ray images, select the optimal treatment based on a patient’s clinical history and the results of clinical trials, and monitor disease and detect early warning signs of deterioration. The use of AI in healthcare will be
driven by the availability of big data on which to train predictive algorithms,
Through smart automation, pain-related behaviours can be captured instantly, allowing the computation of a total pain score and assignment of a pain intensity
which assist (rather than replace) human decision-making, facilitate curiosity- based thinking, enable collaboration and remove mundane tasks, enhancing patient care as a result.
Pain management Every person has the right to receive the best care possible, including to have their pain assessed and managed appropriately. Indeed, the World Health Organisation says it is a human right to have pain managed. However, it is accepted that assessing
pain in people with dementia is challenging, and that many people engaged in the care of people with dementia have not been trained in the assessment of pain in this vulnerable population. Pain in people with dementia can
result in decline in their cognitive status, the manifestation of challenging behaviours, decrease in mobility and the ability to complete daily activities, falls, frailty and an increased reliance on care. PainChek’s technology helps by
providing a valid, reliable and accurate means of assessing pain in people with dementia who can no longer self-report their pain. Manually decoding facial expressions is open to considerable interpretation and subjectivity, whereas PainChek’s artificial intelligence technology provides an objective method of assessing the face for pain indicators. Through the use of smart automation,
Pain and dementia: common challenges for care managers
PainChek has published a free to download white paper ‘Pain and dementia: common challenges for care managers at,’ https://painchek. com/pain-dementia-common- challenges-for-care-managers-uk/. which investigates the complex relationship between pain and dementia, examines how pain affects the behaviour of people living with dementia, and the main issues with assessing pain and how these can be overcome.
38 In the report’s introduction, Vic
Rayner, executive director of the National Care Forum, says: “The ability to assess pain for those living with dementia is fundamental to the provision of high-quality care. The paper outlines the role digital technology can have, and advocates the power of digital to eliminate some of the inconsistencies that have existed in the recording of pain, which once addressed, enables proper pain management techniques.”
other pain-related behaviours can be captured instantly, allowing the computation of a total pain score and assignment of a pain intensity. Once pain is identified and quantified it can be managed appropriately. Better pain management can minimise the negative consequences of pain, while reducing the use of inappropriate medications prescribed to treat BPSD, which are in fact pain related.
Reference 1. Breivik, H., Borchgrevink, P. C., Allen, S. M., Rosseland, L. A., Romundstad, L., Breivik Hals, E. K., et al. (2008). Assessment of pain. BJA 101, 17–24.
TCHE
Professor Jeff Hughes
Professor Jeff Hughes is chief scientific officer at PainChek, the world’s first intelligent pain assessment tool that uses artificial intelligence to analyse micro-facial expressions indicative of pain. A recognised leader in clinical pharmacy research, education and practice, Jeff is a professor in the School of Pharmacy and Biomedical Sciences, Curtin University in Western Australia. He is also an accredited pharmacist and a proprietor of a community pharmacy. Previously, he served as a director of the Pharmaceutical Society of Western Australia and national vice-president and chairman of the Financial, Audit and Risk Management Committee of the Pharmaceutical Society of Australia.
www.thecarehomeenvironment.com• December 2020
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