Non-Pharmacological Approaches to Pain Management in Residential Aged Care: a Pre-Post-Test Study

ABSTRACT

Objectives: The project aimed to evaluate a pain management program (PMP) using non-pharmacological approaches at five residential aged care facilities (RACFs) in Australia.

Methods: The PMP involved a physiotherapist implementing four sessions per week of treatments (massage therapy, TENS, exercises and stretching, or combinations of these). Ninety-five participants were recruited (average age, 83 years; SD = 7.6; 38% men, 62% women; 56% with dementia). Sessions lasted approximately 10 minutes, and residents’ levels of pain were recorded using a 5-point scale before and after each treatment. The intervention period for each participant was the first consecutive 8 weeks in which they received the intervention.

Results: Data analyses showed: (1) a small but statistically significant decrease in the number of as required (PRN) medications; and (2) a decrease in average pain ratings from pre-session to post-session from 2.4 (some to moderate pain) to 1.1 (a little pain). Notably, residents with dementia received lower pain ratings than those without.

Conclusions: Non-pharmacological approaches to pain in residential care settings are effective, especially when two or more are combined. Staff working in residential care settings should rely on best practice to recognise pain in residents with dementia.

Clinical Implications: Non-pharmacological interventions may be effective in reducing pain and reliance on PRN medications in residential care settings, especially when two or more are used. Staff working in residential aged care settings should be provided with training in pain assessment and management, with particular attention to residents with dementia.

KEYWORDS:

• Chronic pain
• non-pharmacological treatments
• nursing homes
• older people
• pain management
• residential aged care facilities

Acknowledgments

The authors acknowledge the residents who agreed for the researchers to access the data on their PMP and medication use during the study; the VIVIR physiotherapists who carried out the interventions; and the Australian Government, which funded the intervention across RACFs in Australia

Disclosure Statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.