Download Guidelines for a Palliative Approach in Residential Aged Care

Pain Assessment and
Management
Module 1: Pain in residents in RACFs
• Pain is a personal experience, occurring when and
where the resident says it does.
• Pain management in RACFs is not addressed well. The
incidence of pain is higher in residents who have
impaired cognition or a communicative disability.
• There are multiple barriers to effective pain management
which are related to false beliefs and attitudes of
residents, families and health professionals
Module 2 : Pain
• The perception of pain can be influenced by the
resident’s mood, past pain experiences, social and
physical situation.
• Pain can be classified as acute, chronic, nociceptive,
neuropathic and incident pain.
Module 3 : Pain Assessment
• Pain assessment tools provide a framework for staff to
obtain an accurate pain assessment and assists in
determining response and on-going treatment for the
pain.
• The pain tool used needs to be appropriate for the
residents cognition abilities.
• Collaboration between doctors nurses, family and other
care staff is the key to effective pain assessment.
Module 4 : Pain Management
• Medications should be tailored to the type of pain and its severity.
• Follow the WHO pain management principles – by the mouth, by the
clock, by the ladder and monitor the outcome.
• Ensure laxatives are prescribed routinely when step-two and step-three
analgesics are prescribed.
• A breakthrough order of a short-acting opioid should always be
prescribed for residents on step-three analgesics.
• Consideration of age-related changes in drug sensitivity, metabolism
and side effects is essential.
• Consider the use of non-pharmacological interventions.
• Health care providers must always be informed of CAM therapies for
safety reasons and to enable the team to develop a comprehensive
treatment plan based on the needs of the resident.