What is the role of a nurse in the management of pain in dementia?

[USWstudent]

[Bananas5]

Sorry i don't understand this question.

Could you elaborate please?

Pat x

[Hidden]

Hello

What do you mean. this will depend on the actual location of the patient is this a nursing home ???

Is the patient in hospital, care will differ in each location, as it can be dependent, on many things

For four years I was acting as next of kin regarding this, it still gives me the hibee jibes

All the best

BOB

[USWstudent]

Oh, sorry, okay, im interested in the role of the nurse in the management of pain in nursing homes, as u can see nowadays, a lot of assessment strategies have been published but it isnt clear what does a nurse do every step of the way. I want to know how nurses take on their role. I believe management is not just up to assessment isnt it? this is also my topic for my dissertation.

thanks for ur reply...

[Calceolaria]

Ah, thought it sounded like a dissertation question ! Perhaps you need to create a questionnaire and also see if any nursing home staff will engage with you ?

[Hidden]

Hello

Really need to attend patient, meetings between Social services, doctor home nurse and patient representatives,then you will see this system not working and if family attend the confusion and distress this causes. Also sit in and see how they work out the nursing care benefits, for those who pay It is all an eye opener

Also see what happens when the patient has to go into hospital,and how they cope,as they pass the patient back to the nursing homes, to relieve beds

You also need to understand the costing systems, and how many patients have to pay for their place also work out how much time is allowed for each patient, and medications that they need to take, and frequency in taking them

Follow the patients journey by the boards on the headboard of the bed, and what happens when medications have to be reviewed in the middle of the night, and the missed entries.

Also how the patient needs to to feed, what happens when time is short.

Putting patients to bed for the new shift arrives,we can go on about this forever, could all this only be happening in our area???

Pain management is according to me a secondary survival problem when the system possibly can go over the heads of patient and family.when the GP has to be called

I am sorry about this everything still is very raw we can only tell what we have found, people need kindness, respect and understanding when dementia comes knocking on the door.

Families need a great deal of assistance also, sometimes it is far from that, and can be very distressing. Patients at death what happens then???.We need to treat the old that would expect from ourselves

Sorry all the best

BOB

[Calceolaria]

I was a hospital social worker and team manager there for years and I can state that pain in the assessment process, is the least considered issue, or it was. It astonished us that pain was never logged much less addressed, in Nursing Assessments. Patients would often be regarded as moaners if they went on too much about being in pain. Goodness knows how much better patients would have functioned if pain had been a category in assessment. Imagine, a Nursing Assessment that doesn't mention pain !!

[teadrinker]

I work in a multidisplinary healthcare setting. A lot of our patients have acute and chronic pain. It is always a question we ask, and we attempt to address the problem of pain otherwise we would not get very far with treatment. But even then, there is a bit of eye rolling going on and comments that pain patients are "stuck" in their ways. I must say that I am not an eye roller, but I can see it from both sides.

As for dementia, I would say that a big problem for people with dementia is not being able to communicate easily, and therefore not being able to explain their pain properly or how effective any medication or treament might be.

[Calceolaria in reply to teadrinker]

Pain is of course addressed forr treatment - medicine is after all now founded on pharmaceuticals - but pain is not an official category or as I said, wasnt, in the Nursing Assessment for funding for care, under Community Care legislation, which is what Bob was raising. This is fundamentally wrong. If it has recently been included in the documentation, then it is not before time. But I doubt it has.

[Hidden]

Hello

BOB here

Both my father and and aunt both had Alzhiemers, both relatives were just husks of themselves when they died, in fact I had the job of acting as next of kin to my Aunt who had no family of her own, this came about after my Father died of the same. This was a decider for me to include Dementia, and Mental Health into a speciality. What I saw, shocked and depressed me, so I began to understand what these two problems mean to patients and families alike. That is how I joined LINK I wanted to make a difference,I had seen the patient who could not tell what was wrong the pain they suffered and the need for more discussion between home and services. Now I will have that chance to help those in pain and try to look after their interests When I return from holiday soon. as voluntary worker

The system needs changing dramatically especially when in hospitals management seem to think of the bottom line, as in some private organisations.

I realise that this is not fully a matter of pain control, although it has when you see inmates, scream for assistance, and ring bells that are not answered, for pain medication and patients waiting for doctors to give ok to staff for heavier meds in organizations, that have a failing in palliative care.

Things need to change and fast, the old deserve a dignified journey to the other side, and not suffer treatment,that is lacking in understanding of their needs.

BOB