Self Directed Learning Package - University of Queensland

More documents

Recommendations

Info

138 • The Palliative Approach ToolkitIf the resident can communicateAsk the resident if they have any pain.Tips:• Older people may deny that they are experiencing ‘pain’. Tryusing other terms like ‘ache’, ‘soreness’ or ‘discomfort’.• Most pain in older people is related to activity. Ask about painwhen they are active e.g. moving, transferring, being turned inbed, not when they are at rest.• Allow enough time for the resident to think about thequestion and reply.• Ask more than one question: ‘does it hurt anywhere?’, ‘do youhave any aching or soreness?’, or ’do you have any pain ordiscomfort’?Severity of pain can be assessed by asking the resident to ratetheir pain on a zero to ten scale where zero is no pain and ten isthe worst imaginable. 2Key PointEveryone has their own pain threshold and it isunhelpful and unfair to compare the scores ofdifferent residents. Instead, compare a resident’sindividual scores across time.If the resident cannot communicate or has acognitive deficitOne of the most difficult aspects of caring for the resident whocannot communicate or is cognitively impaired (e.g. advanceddementia) is identifying whether they are experiencing pain.Thinking PointWhat would happen if Alfred was unable tocommunicate his pain?How would you know if he was experiencing pain?How would you know if a treatment to manage thepain had been effective?Do you use a pain assessment tool for residents whocannot communicate?Key PointThe most effective method to assess pain inresidents who cannot communicate is to observebehaviours and facial expressions.Thinking PointThink of a resident you have cared for with advanceddementia or a communication deficit whom youthought might be experiencing pain. Have youobserved any of the following?• whimpering, groaning or crying• looking tense, frowning, grimacing, lookingfrightened• increased confusion, refusing to eat, alteration inusual behaviour patterns• perspiring, flushed or pale skin, abnormaltemperature, pulse or blood pressure• skin tears, pressure areas, arthritis, contractures,previous injuries.These pain behaviours and physical cues aremeasured in the Abbey Pain Scale. We recommendthe use of this scale for people who are unable tocommunicate.
139 • Self Directed Learning Package - CareworkerSayKey PointSometimes it is an emergencyIf a resident rates their pain as severe, or theyreport chest pains and difficulty breathing: treat itas an emergency and call a nurse immediately.Report your assessmentTry and provide as much information as possible whenreporting to the nurse. This will allow them to decidehow urgently they need to review the resident.Thinking PointWhich of the following do you think will get the bestresponse?Careworker to nurse:‘Alfred appears to have pain. He grimaces when wetransfer him from sit to stand. This is not his normalbehaviour. It has happened three times today so far.He says it is a new pain’.Is much better than:‘Alfred has got pain. You need to see him to sort it out’.DoManage the problemNon-pharmacological therapiesCareworkers can assist in managing a resident’s pain with somesimple yet effective activities. Therapies such as massage canprovide relief for residents.Key PointMake sure you consider the following when you areproviding care to a resident:• Is the resident lying or sitting in a comfortableposition?• Do you take the time to position lifters and otherequipment to prevent pain?• Does the resident have to twist or stretchtheir joints or muscles abnormally when beingtransferred?• Are there any other therapies or strategies(apart from medication) that might help theresident’s pain?Always provide care as directed in the resident’scare plan. If unsure about any aspect, speak tothe nurse.Pharmacological therapiesMedications have an important role in managing many typesof pain.Key PointConsider waiting at least 30 minutes after a residenthas been given pain (analgesic) medication beforeproviding any care that is known to cause pain ordiscomfort.
Page 5 and 6:
3 • Self Directed Learning Packag
Page 7 and 8:
Page 11 and 12:
Page 13 and 14:
11 • Self Directed Learning Packa
Page 16 and 17:
14 • The Palliative Approach Tool
Page 18 and 19:
Page 21 and 22:
Page 24 and 25:
Page 26 and 27:
Page 28 and 29:
Page 30 and 31:
Page 32 and 33:
Page 34 and 35:
Page 36 and 37:
Page 38 and 39:
Page 40 and 41:
Page 42 and 43:
Page 44 and 45:
Page 46 and 47:
Page 48 and 49:
Page 50 and 51:
Page 52 and 53:
Page 54:
Page 57 and 58:
Page 59 and 60:
Page 61 and 62:
Page 63 and 64:
Page 66:
Page 69:
Page 72 and 73:
Page 74 and 75:
Page 76 and 77:
Page 78 and 79:
Page 80 and 81:
Page 82 and 83:
Page 84 and 85:
Page 86 and 87:
Page 88 and 89:
Page 91 and 92: 89 • Self Directed Learning Packa
Page 97: 95 • Self Directed Learning Packa
Page 103 and 104: 101 • Self Directed Learning Pack
Page 106 and 107: 104 • The Palliative Approach Too
Page 108 and 109: 106 • The Palliative Approach Too
Page 139: 137 • Self Directed Learning Pack
show all

Self Directed Learning Package - University of Queensland

Create successful ePaper yourself

Delete template?

Save as template?