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Age Ageing. 2016 April; 45(Suppl 1): i18.
Published online 2016 April 4. doi:  10.1093/ageing/afw033.03
PMCID: PMC4890417

59
A REVIEW OF THE ASSESSMENT AND MANAGEMENT OF CHRONIC PAIN IN LEICESTER CARE HOME PATIENTS AND ITS RELATIONSHIP WITH BEHAVIOURAL AND PSYCHOLOGICAL SYMPTOMS OF DEMENTIA

Introduction Chronic pain is often under diagnosed and inadequately managed in the elderly, particularly in care home residents, many of whom may have dementia with associated psycho-behavioural disturbance. Studies have shown a link between effective pain management and improvement in behavioural symptoms of dementia.

Methods As part of routine practice, we carried out a Comprehensive Geriatric Assessment with a focus on pain prevalence and management in 105 patients in Leicester City Care Homes. Patients were assessed for undiagnosed pain and behavioural disturbance, and pain therapy was optimised. After a minimum of three months, we looked at pain scores, behaviour and other health outcomes for these patients.

Results The majority of patients (72%) were known to have chronic pain yet 31% had uncontrolled pain; only 5 of the 22 care homes involved routinely used pain tools. 86% of patients had a dementia diagnosis, with two-thirds of these patients also having BPSD (behavioural and psychological symptoms of dementia). Approximately 10% of patients showed a possible link between increased BSPD and pain.

At follow-up, 16 patients had received treatment intervention. 94% of these patients had reduced pain, and there was an 89% improvement in BSPD. The number of both hospital admissions and falls were reduced. All care homes visited at follow-up showed an improvement in pain assessment.

Conclusions Chronic pain is poorly assessed and managed in care home residents, where there is a high burden of dementia. Providing education for care homes on the importance of managing pain resulted in significant improvements in pain assessment. Effective management of pain can reduce pain scores.


Articles from Age and Ageing are provided here courtesy of Oxford University Press