According to a study in September issue of the Journal of Clinical Nursing, relatives and healthcare staff find it hard to diagnose pain levels in nursing home residents accurately, especially if they are cognitively impaired with illnesses such as dementia or unable to speak. The findings have led experts from The Netherlands to call for nurses to be given more education about how to assess and treat chronic pain. They would also like to see relatives being given more information about pain and for both parties to use other methods, like encouraging greater mobility and providing soothing massages, to alleviate pain.
"When the team interviewed the residents without cognitive impairments they found that all of them reported pain in the last week, but that only 89 per cent of the caregivers and 67 per cent of the relatives were aware of that pain" says Dr Rhodee van Herk. "However, if they were aware that the patient had experienced pain, the nurses and relatives gave it a median score of six out of ten, with the same score reported by the patients."
Researchers led by the Pain Expertise Centre at the Erasmus Medical Center studied 174 nursing home residents – 124 who had cognitive impairments and 50 did not. They also spoke to 171 nurses and 122 relatives. Six nursing homes took part in the five-year study, with the researchers speaking to the patient, someone responsible for care and, wherever possible, a relative who had regular contact with the patient. In some cases nurses reported back on more than one patient.
Eight-three per cent of nurses and 65 per cent of relatives were certain about the level of pain the patient had experienced in the preceding week and 83 per cent of caregivers and 58 per cent of relatives were certain about pain at rest.
"Our study shows that nurses and relatives find it hard to accurately assess pain in nursing home residents, especially if the resident has a cognitive impairment, such as dementia, or is unable to speak" concludes Dr van Herk.