Don’t miss this timely article prepared for the deVeber Institute and authored by Jean Echlin (RN, MSN), Kathryn Pfaff (RN, PhD) and Aleshia Johnston.
Co-Morbid Pain and Dementia: A Case Study as Impetus for Change
There is a need for Canadian healthcare leaders and policy makers to examine the issues surrounding pain assessment and management in the institutionalized elderly. According to the Canada Health Act (Government of Canada, 1984, last amended 2012), healthcare policy should “protect, promote and restore the physical and mental well-being of residents of Canada” (p. 5), and that this includes barrier-free access to healthcare services regardless of age, health status and setting. Despite this legislation, long-term care residents with dementia and/or an inability or decreased ability to communicate are less likely to be assessed and receive treatment for pain than those without similar impairments (Horgas & Miller, 2008; Kaasalainen et al., 2007; Martin, Williams, Hadjistavropoulos, Hadjistavropoulos, & MacLean, 2005; Morrison & Sui, 2000). This reality competes with Ontario’s accepted definition of long-term care homes as places where physical and psychological needs, including comfort, are safely met and where “every resident has the right to receive care and assistance towards independence based on a restorative care philosophy to maximize independence to the greatest extent possible” (Ontario Ministry of Health and Long-Term Care [OHMLTC], p. 56). Further, the Act emphasizes that those who are unable to communicate must have pain assessed and managed using clinically appropriate tools and strategies (OHMLTC).