A lack of staff and education plus poor communication are hindering effective pain management in residential aged care, research from the National Ageing Research Institute shows.
The research aimed to inform the development of the Pain Management Guidelines Toolkit that NARI is developing with the Australian Pain Society for residential aged care facilities to accompany the recently released Pain in Residential Aged Care: Management Strategies.
The toolkit aims to provide clinicians, allied health professionals and aged care staff easy-to-access guidelines and resources for recognising and treating aged care residents’ pain.
The research involved 33 interviews with aged care home staff, residents and family members plus other experts about the core issues of pain management in residential care and what to include in the toolkit to improve practices.
The study found a lack of staff is the main barrier to effective pain management, said NARI research assistant Anabelle Peck.
“Number one, there is not enough staff and that leads to staff having major time constraints and they can’t focus on providing the best possible care. Good pain management requires time to be spent with the resident,” Ms Peck told Australian Ageing Agenda.
“It’s difficult to identify pain because identification of pain requires you to know a resident to be able to pick up signs and symptoms,” she said.
Ms Peck will discuss the research and the systemic barriers preventing effective pain management in residential aged care at the Australian Association of Gerontology conference next week.
The study also found a need for broad and structured pain management education programs for aged care staff.
Ms Peck said staff often report they don’t get any training or education around pain management.
“It’s not an ongoing priority in facilities and it’s also connected to time constraints. Often staff said there are these training programs available, but they can’t do that during their work times and it would have to be outside work, which is a real issue for them,” she said.
The research identified communication between residents, family members and multidisciplinary teams as the third core barrier, Ms Peck said.
“Staff struggle to effectively collaborate within facilities. And it was emphasised that carers like personal care workers have a key role to play in identifying pain in residents, but they’re not empowered to do that or to speak up to nurses or other staff.”
She said family members also reported a lack of communication from facility staff.
Ms Peck said the barriers were due to the marketisation of the aged care sector.
“Providers are now incentivised to prioritise profit over quality care. And it’s not in all cases, but it is definitely evident,” she said.
“To mitigate the impact that marketisation has had, there needs to be more effective government regulation and stewardship.”
Ms Peck said the toolkit would reflect the pain management journey from identification to assessment, treatment including non-pharmacological and pharmacological approaches, evaluation and monitoring.
- include a section to guide management staff on implementing the toolkit in the context of residential aged care systems and quality standards
- be designed as a quick and easy reference tool accessible to all residential aged care staff with a strong focus on person-centred care
- include printable resources such as information sheets and posters for staff, residents and family members.
The toolkit will be freely available to the residential aged care sector in April next year, she said.
The project is funded by the Federal Government Dementia and Aged Care Services fund.
The AAG Conference is taking place as a virtual event on 18 – 20 November.
Australian Ageing Agenda is a media partner of the AAG.