Pain Assessment in Older Adults with Cognitive Dysfunction

POSTER

Pain Assessment in Older Adults with Cognitive Dysfunction Karen A. Gilbert, BSN, RN, OCN, DNP-student Primary Care Nurse Practitioner Program - FNP & AGNP BACKGROUND • Pain is not a normal part of aging, yet the prevalence of pain increases with age.  Pain is experienced by >85% of older adults. • Failure to treat pain may lead to severe morbidity and mortality. • Chronic pain and depression have a high rate of co-occurrence, yet depression remains both under-recognized and under-treated. AIMS • The presence of cognitive disorders obfuscates the assessment of pain when communication abilities are compromised.  Only objective pain scales reliably capture pain in non-communicative patients. • PROCEDURES PACSLAC is the only validated pain assessment tool that addresses all 6 behavioral pain assessment domains recommended by the American Geriatrics Society. PURPOSE & OBJECTIVES Purpose: Create an educational module for health care teams to increase awareness of objective measurement of physiologic discomfort in older adults with cognitive dysfunction. Objectives: • Develop and deliver an educational module to improve knowledge and use of a validated pain assessment tool for older adults (>65 yo). • Implement and evaluate the education. METHODS • Educational module presented to health care team at a private memory care facility. • Team consisted of licensed and unlicensed personnel (MD, PA, BSN, RN, LPN, CNA, & caregivers). • Demographic statistical description of the participant population. • Pre- & post-test surveys administered to assess for gain in knowledge. • Paired t-test statistical analysis to determine significance of knowledge gain. Pain Assessment Checklist for Seniors with Limited Ability to Communicate – II PACSLAC-II • Created by Canadian Registered Doctoral Psychologist Thomas Hadjistavropoulos, PhD, ABPP, FCAHS. • PACSLAC-II is a derivative of the original PACSLAC, this 31-item tool is validated for use by both licensed providers and unlicensed laypersons in the early detection and treatment of pain in older adults. RESULTS: RESULTS • Demographics • Age 40 (+ 16.71) years • Gender: 75% female, 25% male • Race/Ethnicity: 67% Caucasian, 17% Hispanic, 8% Pacific Islander, 8% unidentified • Educational level: 8% MD, 8% PA, 8% BSN, 16% RN, 8% LPN, 32% CNA, 16% HS. • Pain assessment pre-test score 6.53 (+ 3.54) • Pain assessment post-test (9.67) (+ 2.55) • 15 pt scale • p-value = 0.001, indicating statistical significance CONCLUSIONS & FUTURE IMPLICATIONS This project revealed that education for those who care for older adults with cognitive dysfunction is effective in improving pain assessment knowledge, potentially allowing for improved care. Future study is needed to determine whether this pain assessment tool is used at this facility, and whether it leads to: • Reduced incidence of mood and behavioral disorders, • Reduction in the overuse of healthcare resources, • Improved patient outcomes, and • Increased patient satisfaction scores.