Larissa McIntyre has been working in aged care for two decades and specialising in palliative care, where her passion lies, since 2004. Today, as a Nurse Practitioner and Head of Clinical Services Residential Aged Care, her role involves reviews of clinical practice, including management of pain, across 23 facilities, as well as meeting with residents’ families to talk about end-of-life planning.

“99.5% of our residents will die either with us or in a hospital, so end-of-life care is really, really important,” Larissa says. “We need to get it right the first time, because we don’t get a second chance. Providing that excellence in care as people are dying and supporting their families is critical.”

The majority of residents in the facilities Larissa oversees are living with dementia or life-limiting illnesses, and for many, this means dealing with chronic pain. Although completely eliminating pain may not be possible, ensuring comfort and dignity is paramount for residents and their loved ones.

“For these people, you can’t eradicate chronic pain but you can make them more comfortable and give them a better quality of life,” Larissa says. “Everybody I know who works in palliative care has that passion for trying to make someone’s last few days, weeks, months or sometimes years better.”

“Most family members say ‘I just don’t want Mum or Dad to be in pain’. The research tells us that’s the biggest fear people have about dying – that they will be in pain and the pain won’t be managed.”

Supporting quality end-of-life care

Anglicare’s management team made the decision to implement PainChek® in 2021 following a review of the organisation’s pain management processes. They were previously using a combination of tools, including the Abbey Pain Scale, but found that these methods didn’t provide the consistency and objectivity needed to support best-practice pain management.

“The primary starting point [in effective pain management] always has to be about the assessment. What type of pain is it? How severe is this pain? How long has that pain been there? How does it interrupt your day-to-day life? For people who are living with dementia, it’s really difficult to do that kind of pain assessment. That’s where PainChek® has been quite revolutionary,” Larissa says.

Currently, Anglicare’s clinical care team conducts around 3,800 pain assessments a month using PainChek®, and each month this figure keeps growing. Larissa has experienced first-hand how PainChek® enables more objective pain assessment, and in turn, improved pain management.

“I had one resident with dementia who hated getting her back and hair wet – she would scream and thrash,” Larissa shares. “I told the team to do a pain assessment using PainChek® and they looked at me like I had two heads. But guess what? Her pain score was severe. All people could see was the behaviour she was demonstrating but not the cause. Based on that assessment, I was able to speak to her daughter and put the resident on pain relief, and within an hour she was quite comfortable and not distressed.”

PainChek® not only facilitates best-practice end-of-life care for Anglicare’s residents, but also supports ongoing compliance with the The Aged Care Quality and Safety Commission’s Quality Standards.

“The validity of the PainChek® is so significant that when I rewrote the pain policy and procedure, I included a guideline to use it as our primary assessment tool.”