Aged Care Insite Issue 108 | Aug-Sep 2018 | Page 36

technology What insights have surprised you about PainChek? One of the things we’ve gleaned from this whole process is that it helps carers identify the presence of pain when it isn’t obvious, and it helps them quantify the severity of pain when it is obvious. Also, we’ve introduced a facility to monitor the effectiveness of intervention. So it’s a little bit like a thermometer: you may know somebody has a fever, but you don’t know what the fever level is. The thermometer gives you the ability to identify the temperature and see how the therapy impacts on reducing it. PainChek is the same: it assesses the quantity of pain, and then, with the builtin monitoring capability, it shows how you’re affecting that pain through treatment. BETTER PAIN CARE Barossa Village in South Australia houses 100 residents and has been using PainChek since November. Aged Care Insite spoke with general manager Matt Kowald about the app and asked how it had changed the way they assess pain. Kowald said the tool had altered the way the centre assessed pain and enabled staff to provide better pain care to the residents. “The automatic reporting feature has improved the efficiency of data handling, and simplified reporting for accreditation and auditing purposes,” he said. Kowald said it refocuses people to show that pain is a factor for behaviour. He also pointed out the added benefits for non- users, saying that families like it as it supports someone who is non-verbal. “It’s nice to put a number on pain. It’s like taking your blood pressure: you have a number that’s measurable,” he said. It’s actually taken the spotlight away from pain and gone, “Right, well, let’s have a look at this holistically and say this behaviour could be related to the pain.” So it’s been as much about managing behaviours of concern in people with dementia as opposed to managing pain. It’s a bit of both. What differences has the tool has brought to the identification of pain management? Again, it’s made it first and foremost in people’s minds. Any time you introduce something new, it reinvigorates the thinking around it. Also, with younger staff there’s that, “Oh, technology I’m going to grasp hold of it and use it.” So it’s given people something else to hold on to around managing pain and looking at behaviours. I think it’s just raised the profile. It’s taken it from something that is difficult to quantify to something where carers can say, “I’ve got some hard evidence around this, and I can present it to my GP or my geriatrician to say that this is the problem and this is how we need to manage it.” So it gives the nursing staff more power, which makes for better clinical decision-making. ■ ACI: Matt, as a provider, why did you decide to implement this product into the village? MK: Actually, it was a simple choice in the end. I saw the demonstration by Dementia Support Australia when they came to see a resident here in November. It was really quite compelling that a resident we were looking at all the time was exhibiting behaviours that we had put down to their managing dementia, and it really came down to pain. And then after seeing that demonstration, it was like, well, if you’ve got a memory support unit and you’re dealing with people that are non-verbal, it’s difficult not to have that tool in your arsenal. How have residents reacted to this introduction? The residents are quite used to technology here. We often use iPads for consultations with medical staff, and the residents see us using iPads with them on a regular basis. So even people that have advanced dementia don’t seem to mind seeing their face on a screen, which is essentially what happens most of the time. And families – which are probably the quality control measure in this case – love the fact that we’re investing in a technology that supports people who aren’t able to verbalise their pain. How has this impacted the nursing staff? I was lucky enough to spend some time with Jennifer Abbey a while back. The Abbey pain score is what we’ve been using for a long time. With many pain scores, people tend to just tick the boxes, whereas PainChek tends to make people go through the system. You actually have to stop and spend time with the resident. I keep saying it’s like using a blood pressure machine. You actually have to put it on and go through a process, and you can’t not go through one part of that process. So it makes people systematic. PainChek is approved by Dementia Training Australia. Based on the Abbey pain scale, it recognises the benign micro facial expressions that indicate pain. agedcareinsite.com.au 33