Dementia care
Using medtech to tackle the pain assessment problem
Associate professor Dr. Kreshnik Hoti, senior research scientist at PainChek, explains the findings of a recent study of the Australian company’s pain assessment technology at a UK care home, and how it could be used to improve the quality of life for residents living with dementia
The importance and potential of digital healthcare solutions have been brought to the fore during the last two years or so, with health and social care facilities increasingly calling on medtech devices to tackle the challenges of care delivery in a world with Covid-19. Pain assessment is one area that is successfully transitioning towards being digital- and technology-first. Pain is now recognised as an important
reason for behavioural changes in people living with dementia, but pain and dementia share a complex relationship. While dementia does not directly cause pain, people living with dementia are at higher risk of persistent pain. Furthermore, recent research suggests chronic pain could be an early symptom of dementia, with people reporting more pain many years before their actual diagnosis of dementia.1
The relationship between pain and dementia Pain in elderly people with dementia is a major concern,2,3
with research
consistently reporting poor outcomes in terms of inappropriate administration of analgesics and incorrect recognition of pain.4,5
Approximately 80 per cent
of people living with dementia in care homes experience pain,6
and this can
be due to a wide range of reasons, from osteoarthritis and pressure sores to
injuries sustained from falls. Despite the prevalence of pain in people living with dementia, it is still poorly recognised and undertreated, emphasising the need and importance to develop an effective means to recognise and evaluate pain in this population.7 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
The study set out to address the concerns around observational pain assessment instruments, and the need for a highly valid means of assessing pain in people with advanced dementia
December 2021 •
www.thecarehomeenvironment.com
to have pain managed. Persistent and untreated pain in dementia has been linked with an increased level of cognitive deterioration.8 Up to 90 per cent of people with
dementia show behavioural and psychological symptoms of dementia (BPSD).9
There is a wide range of
these symptoms including agitation, hallucinations, delusions, anxiety, or depression.
In addition, BPSD is commonly
associated with cognitive decline in dementia, with symptoms usually being present from the early stages of dementia and gradually worsening over time. This negatively impacts quality of life and the progress of the condition.10,11 The presence of BPSD has also been associated with incorrect use of antipsychotic medication. In particular, pain has a negative impact on BPSD,
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