Interventions after diagnosing pain in nursing home residents with dementia: the pilot implementation of an observational pain scale (PACSLAC-D)

• Published in: Tijdschrift voor gerontologie en geriatrie Vol. 42; no. 2; pp. 67 - 78
• Main Authors: van t'Hof, C E, Zwakhalen, S M G, Hamers, J P H
• Format: Journal Article
• Language: Dutch
• Published: Netherlands 01.04.2011
• Subjects: Aged; Aged, 80 and over; Analgesics - therapeutic use; Dementia - psychology; Female; Homes for the Aged; Humans; Male; Nursing Homes; Pain - diagnosis; Pain - drug therapy; Pain - psychology; Pain Measurement - instrumentation; Pain Measurement - methods; Pilot Projects; Psychometrics - methods
• ISSN: 0167-9228

Pain occurs regularly among nursing home residents with dementia. There are indications that appliance of structural pain assessment can contribute to the adequate diagnosis of pain. The aim of this study is to gain insight into applied interventions after diagnosing pain with an observational pain scale (PACSLAC-D) among nursing home resident with dementia. During a six week period pain was measured twice a week, among 22 residents of a psychogeriatric nursing home ward, using the PACSLAC-D. Interventions undertaken as a result of a pain score were inventoried on a data-sheet. After the third and sixth week implementation of pain assessment was evaluated. In total 264 pain assessments using the PACSLAC-D were conducted. Of all scheduled standardized measurements 90% was completed. Sixty observations resulted in a pain score. Completed datasheets (N=39) showed that a pain score often (N=17) did not result in any intervention. The majority of interventions that were undertaken consisted of a non pharmacological approach (N=19). Evaluation meetings indicated that the PACSLAC-D was considered useful, though the chosen procedure of standardized measurements twice a week was not yet ideal. This study demonstrates that although there was a high compliance rate, pain relieving interventions were not frequently applied.