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Care homes found wanting in pain management for dementia


Unqualified care workers are routinely assessing pain in patients with dementia in nearly half of independent care homes, indicates a survey carried out by Napp Pharmaceuticals.

It conducted a survey of 100 independently owned care homes on the provisions they had in place for identifying and managing pain in dementia patients.

Just under half of the care homes questioned, 46%, reported that support workers regularly assessed pain.

In addition, 22% of homes surveyed in England had no written guidelines in place for assessing pain in those less able to communicate, rising to 25% for homes in Wales.

Meanwhile, as many as 30% of the homes surveyed had not reduced their use of antipsychotics in dementia, despite government guidelines  to do so, and 54% reported that less than half of their patients were currently taking analgesics.

Commenting on the findings, Alzheimer’s Society chief executive Jeremy Hughes said: “People with dementia can struggle to communicate and may find it difficult to express that they’re in pain.

Jeremy Hughes

Jeremy Hughes

“This means they miss out on being given pain relief and suffer in silence or, even worse, are given dangerous antipsychotic drugs.”

He added: “Training and supporting staff enables care homes to provide the best quality care possible and allows people with dementia to be treated with the dignity and compassion they deserve.”

The pharmaceutical company, which has a background in pain medicines, has created the “See Change: Think Pain” awareness campaign for carers and healthcare professionals to help identify pain in people with dementia. It includes a simple mnemonic to assist carers:

  • Pick up on mood changes
  • Assess verbal cues
  • Inspect facial expressions
  • Notice body language


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Readers' comments (3)

  • michael stone

    This is important - it is rather like Tink's recent comment elsewhere, about first ruling out physical causes for odd 'psychological' behaviour.

    Everyone tends to be 'grumpy and possibly 'badly behaved'' if they are in ongoing pain, and if dementia patients are in pain but cannot tell you, then it would be all too easy to put the 'challenging behaviour' down to the dementia, instead of the pain the person is in. Then instead of treating the pain, you get people inappropriately treating 'the behaviour' via sedatives, etc.

    It is important - I've also heard it discussed before (on the radio or TV), so it is known about.

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  • Tinkerbell

    michael stone | 15-Feb-2014 9:53 am

    Yes, it's called chemical restraint but still leave the person in pain. Cruel!

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  • michael stone

    tinkerbell | 15-Feb-2014 11:52 am

    Quite, Tink - although I'm not sure exactly how much pain it leaves the patient in (presumably depends on exactly what the inappropriate treatment was), it is definitely also likely to reduce the patient's 'interactivity with the world' in an entirely inappropriate way.

    And as a cynic, and I hope this is being stamped out, I can see how bad HCPs might be trying to use any justification to hand, to sedate dementia patients if that leads to an 'easier life for the HCPs'. You can even see how 'good but very over-worked' HCPs, might stop resisting that practice (unethical - although leaving HCPs so overworked that 'good ones' might lapse that way, also looks unethical, doesn't it).

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