I am working with Bristol PCT on a project to improve pain assessment and management in residents of nursing homes who have dementia. Pain in dementia is underestimated and causes severe and prolonged suffering.
The National Dementia Strategy includes pain and end of life care as some of their targets for improved services. The PAIN (Pain Assessment in Nursing Homes) project aims to educate nursing home staff and provide a new simple, objective assessment tool that will hopefully be very usable and therefore widely used (currently use of assessment tools is sporadic at best).
We have run a pilot survey of staff to see what level of experience they have and what they think they need to be better at recognizing pain: a large number said they wanted more training and even more asked for a new assessment tool so hopefully we will give them what they are looking for.
After a number of education days, we are going to audit the use of painkillers and also look at other sedative drugs that may be being over-used at present to treat difficult behavior in patients who in fact are acting like that because of unrecognized pain.
I am really hoping this will be the start of something that will spread further: I’m a member of the British Pain Society Pain in Older Adults SIG (special interest group) so will be liaising with other members with that purpose in mind.