The distress of untreated pain

Wednesday, 17th January, 2018

UNTREATED TORMENT – Four out of five aged care residents live with chronic pain.

FOUR out of five aged care residents are living with chronic pain yet half are being left to suffer because of inadequate treatment, or no treatment at all.

Many residents with dementia are unable to verbalise their pain levels to staff. Their untreated torment can cause disruptive behaviours leading to the use of chemical (psychotropic drugs) or physical restraints.

This hellish vision comes from advocacy group Painaustralia, which earlier this year made a submission to the Review of National Aged Care Quality Regulatory Processes set up by the federal government after shocking cases of abuse at the Oakden Dementia Unit in South Australia were made public.

However, the organisation is disappointed that pain management was ignored in the review’s final report.

Painaustralia says more than half of all aged care residents have dementia, with two in three requiring high-level care to manage behaviours. “This suggests a great deal of pain goes unacknowledged or treated in aged care facilities due to dementia and cognitive impairment reducing the capacity for appropriate detection.”

The organisation said many aged care staff received no training in pain assessment; and when pain was assessed there was too little allied health support. In addition, the government’s Aged Care Funding Instrument did not provide adequate funding for pain assessments and support of appropriate person-centred care plans.

Painaustralia chief executive Carol Bennett said untreated pain not only impacted the resident but  brought distress to the family and a greater burden of care on staff.

“While access to pain management is acknowledged globally as a fundamental human right and the Australian government recommends best-practice care for aged care residents, Australia’s aged care facilities are falling short of effective pain care,” the organisation’s submission to the review said.

Ms Bennett said it was “amazing” that the issue of pain was not addressed in such a major report talking about aged care quality.

“Our ageing population deserves more,” she said.

Key issues

The Painaustralia submission identified five key issues:

  • Inadequate education and training of residential aged care staff leading to under-reporting of pain
  • Inadequate pain assessment reporting standards and protocols
  • Insufficient support for allied health care and best-practice pain management
  • Insufficient education about best-practice pain management for aged care residents
  • Lack of a co-ordinated national approach

 Pain a priority: minister

Aged Care Minister Ken Wyatt said ensuring best-practice pain management was a top priority and an integral part of the government’s response to both the National Aged Care Quality Regulatory Processes Review and Aged Care Legislated Review.

He said he was working with Pain Management Australia to help aged care providers further improve pain management. This will include developing guidance and fact sheets for providers and their staff.

Mr Wyatt said Common­wealth law requires approved providers to meet accreditation standards, which include the requirement to ensure all care recipients are as free as possible from pain.

However, opposition aged care spokeswoman Julie Collins said it was not good enough to have older people suffering untreated chronic pain. “Labor has said the Aged Care Funding Instrument is broken and the government needs to act,” she said.

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