Algorithm-based pain management for people with dementia in nursing homes

Manietta, Christina; Labonté, Valérie; Thiesemann, Rüdiger; Sirsch, Erika; Mohler, R. Albert

doi:10.1002/14651858.cd013339.pub2

Cited by 12 publications

(11 citation statements)

References 100 publications

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“…Care workers, particularly in care homes, but also in hospital settings, reported a process that because they engage in more personal care activities such as washing and toileting, they were better able to make early, timely detection of pain. 3,24,29,41,48,54,56,57 This would be reported to senior colleagues. However, there is some reluctance to do so regarding carer's perceived qualification in some instances.…”

Section: Meta-ethnographymentioning

confidence: 72%

“… 23 , 30 , 36 , 41 , 45 , 46 , 47 , 49 , 52 Surveys with qualitative findings were presented in three studies 27 , 32 , 42 whilst four used a combination of focus groups and interviews. 29 , 37 , 38 , 56 The professional roles of these care home workers ranged from care assistants, registered nurses, physicians and care home managers. The frequency of these is presented in Table 2 .…”

Section: Resultsmentioning

confidence: 99%

“…Data were gathered from care home staff in 19 studies of 510 individuals. 3,23,27,29,30,32,[36][37][38]41,42,[45][46][47][48][49][50]52,56 Data were collected using focus groups in three studies 3,48,50 and by interviews in nine studies. 23,30,36,41,45,46,47,49,52 Surveys with qualitative findings were presented in three studies 27,32,42 whilst four used a combination of focus groups and interviews.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…This challenge was reported in four studies undertaken in care home, community and hospital setting. 3,25,54,56 Even when pain is detected, there was a reluctance to foster and use connections to evaluate treatment outcomes. Barry et al 30 and Corbett et al 3 reported pain the person with dementia in their family experienced was undertreated and unnoticed by care home staff.…”

Section: Meta-ethnographymentioning

confidence: 99%

“…Irrespective of the type of treatment, there was a reluctance to use any form of post-treatment evaluation across the literature, be that acute hospital care or home-based care. 3,36,46,56,57 Theme 4: Tension over treatment options. There was a consistent theme from moderate certainty evidence that carers and healthcare workers had a reluctance to suggest non-pharmacological methods of pain relief which they could offer, feeling they did not have the training to offer such approaches.…”

Section: Meta-ethnographymentioning

confidence: 99%

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Pain management for people with dementia: a cross-setting systematic review and meta-ethnography

Smith

Lockey

Johnson

et al. 2022

British Journal of Pain

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Background Pain management for people with dementia is challenging. There is limited understanding on the experiences of pain management from people with dementia, but also from those who support them. This study synthesised the qualitative evidence to explore the perspectives of people with dementia, their family, friends, carers and healthcare professionals to pain management. Methods A systematic literature review was undertaken of published and unpublished literature databases (to 01 November 2021). All qualitative research studies reporting the perspectives of people with dementia, their family, friends, carers and healthcare professionals to managing pain were included. Eligible studies were appraised using the Critical Appraisal Skills Programme (CASP) qualitative appraisal tool. A meta-ethnography analysis approach was adopted, with findings assessed against the GRADE-CERQual framework. Results Of the 3994 citations screened, 33 studies were eligible. Seven themes were identified from the data. There was moderate evidence from six studies indicating inequity of pain management for people with dementia. There was moderate evidence from 22 studies regarding anxieties on cascading pain information. There was moderate evidence from nine studies that familiarisation of the person with pain, their preferences, routines and behaviours were key factors to better pain management. Consistently, carers and healthcare professionals had a low opinion of the management of pain for people with dementia, with tensions over the ‘best’ treatment options to offer. This was associated with poor training and understanding on how pain ‘should’ be managed. Conclusion The findings highlight the challenges faced by people with dementia and pain, and those who support them. Improvements in education for people who support these individuals would be valuable across health and social care pathways. Supporting family members and relatives on pain experiences and treatment options could improve awareness to improve quality of life for people with dementia and pain and those who support them.

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