Brightwater Care Group
With over 100 years in the WA community, Brightwater Care Group is one of Perth’s most trusted aged care and disability support providers. Brightwater’s services span home care, residential aged care, retirement living, and disability care and assistance, providing a range of care services for over 800 people.
Brightwater successfully implemented PainChek® across its 11 Residential Aged Care homes in early 2021, providing staff with the latest pain assessment technology to conduct high-quality, objective assessments.
Brightwater Madeley, part of the Brightwater group, is a 110-bed facility catering to a variety of residents, including those living with dementia and those with high care needs.
PainChek®: Transforming Pain Management
- PainChek® has become the standard tool for assessing pain and evaluating pain management strategies in residents with dementia.
- A considerable improvement in pain management and behaviours, together with a notable reduction in psychotropic prescription and administration supported by PainChek® assessments.
- An increase in staff awareness and staff confidence when dealing with pain in residents with cognitive impairment or dementia.
- Ease of access and administration – with easier access to stored assessments and electronic charts, there has been increased and more effective input from GPs with ongoing review crucial.
Addressing Challenges with PainChek®
A resident was referred to the allied health team after a number of falls, surpassing 11 incidents in a single month, often with multiple falls in a single day. The resident carried a diagnosis of Alzheimer’s disease, accompanied by behavioural symptoms such as agitation, anxiety, aggression, depression, and an inability to communicate verbally. This presented a challenging task for the team and prompted the use of the PainChek® pain assessment app to accurately assess and record pain levels of non-verbal residents.
Outcomes and Impact
Thorough education and training in pain assessment facilitated the widespread use of PainChek® by staff across the facility, which is now the standard tool for evaluating pain management strategies in residents with dementia.
A post-fall physiotherapy assessment was performed and the team conducted a comprehensive review of the resident to eliminate the possibility of an acute injury causing pain. This thorough evaluation encompassed a palliative team review, a urine sample analysis to rule out medical causes such as a UTI contributing to the falls, an update of the pain management form, a GP referral for medication review, and input from allied health professionals to assess equipment and safety measures.
Following a GP review, an increased dosage of a narcotic patch was administered, supplemented by regular paracetamol, and as-needed (PRN) doses of morphine and oxycodone. Additionally, hourly check-ins were introduced, conducted by the care team, in conjunction with routine repositioning. This combined approach aimed to maintain the resident’s comfort, minimise the risk of additional falls, and prevent potential fractures or other injuries.
With the implementation of interventions, a notable decline in falls was observed, with no recorded falls for two consecutive months. As the falls decreased, the resident’s condition stabilised. Medication adjustments were made when there was a relapse in recorded falls.
Following the relapse, PainChek® was utilised, with video assessments consistently recording scores in the 20s, demonstrating the resident was experiencing severe pain. A GP review was initiated, leading to an increase in the narcotic patch dosage. Regular PainChek® assessments were continued to track the effectiveness of the intervention. Subsequently, no falls were recorded in the following months and the team observed a clear reduction in behaviours.
Read more about the PainChek and Brightwater Aged Care partnership
Jackson Principe, Senior Physiotherapist at Brightwater Care Group
“Residents are agitated and uncomfortable and it’s not always attributed to pain because of their worsening cognition – particularly those with dementia. PainChek® is good for us because we have a more accurate result, which can be documented or recorded and ensures pain is not getting missed.”
