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Study explores pain’s role in BPSD

Almost two-thirds of aged care residents with behavioural and psychological symptoms of dementia (BPSD) live with pain, a new study has found.

The research also found that for almost half of that group their pain was moderate to severe.

The study involved nearly 500 residents who were referred to Dementia Support Australia for BPSD and were no longer able to communicate the presence or intensity of pain. Researchers, led by Mustafa Atee, a Curtin University PhD candidate who works with HammondCare’s Dementia Centre in Western Australia, used the device PainChek to measure pain.

Atee said the research confirmed that pain was a significant contributor to BPSD.

In fact, compared with the no pain group, the pain group had 25.3 per cent more neuropsychiatric behaviors and 33.6 per cent higher severity of these behaviors, while caregivers experienced 31.4 per cent higher total distress.

“If pain is not managed appropriately, it can trigger a cascade of adverse events affecting not only the person with dementia, but also the people who care for them,” Atee said.

“For the person with dementia, uncontrolled pain can lead to inappropriate prescribing of medications such as psychotropics, and associated side effects including falls, fractures and even death.”

He added other adverse events may include frequent or longer hospital stays, impaired cognition and reduced quality of life.

“Obviously this may also impact care staff causing distress, burnout and increased turnover…”

The study’s authors said the research raises the need to incorporate pain assessment and management as part of standardised behavioural assessment and treatment protocols.

They added that as the source of referral for the study was residential aged care facilities across Australia, the findings “raise the question of whether this population is receiving adequate pain control”.

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