PainChek® has been featured in The UK Sunday Times, highlighting how AI is transforming care homes in the UK. The article highlights PainChek® as a key innovation helping care staff better assess and manage pain in residents with dementia.
Originally Published in The Sunday Times, Friday November 22 2024
Inside the AI care home: the smart tech making old people safer
High-end care homes are now monitoring residents’ facial expressions and night-time movements using artificial intelligence. Could smart tech save a failing system — or is it a dangerous shortcut to cutting staff numbers?
The care home manager Christine Bunce gestures at a list of names and room numbers on the computer screen in her office, pointing out one highlighted in orange. “I can see Derek has had four disturbed nights this week,” she says. “There could be something wrong, like an infection, so I’ll talk to his carers this morning and see whether we need to call the GP.”
She can chart Derek’s night-time activity on a computer dashboard thanks to an infrared and acoustic monitor in his room that detects his movements. The device, called Ally Cares, uses artificial intelligence (AI) to learn his behavioural patterns, and alerts staff to anything unusual, such as if he uses the lavatory more frequently or is restless.
This is just one of the new AI and smart technology systems coming to care homes around the country. Others include devices that predict and prevent falls, adjust air quality, detect when someone with dementia is in pain — even monitor how regularly staff sanitise their hands.
Bunce oversees the welfare of 73 residents, about half of whom have dementia, at the upmarket KYN Bickley care home in Bromley, southeast London, where room-only full-board costs £1,650 to £2,128 per week and care packages start at £250 per week. Having spent three decades working in elderly care before starting her job here last year, she believes smart tech and AI will “genuinely make a difference” to some of the issues she’s witnessed over the years, including residents being repeatedly woken for checks at night, falls being missed and disparities in how each carer interprets residents’ needs.
Staff at KYN are also using an AI app called PainChek, developed from an idea by Professor Jeff Hughes at the School of Pharmacy at Curtin University in Western Australia. The app uses the camera on an ordinary smartphone or tablet to scan faces for tiny changes called micro-expressions to detect pain in non-verbal residents, including those living with advanced dementia. The company does not disclose the cost as it varies from home to home, but one Canadian evaluation of the technology said it was typically $50 (Canadian dollars — about £28) per bed per year.
Multiple studies, including by the Picker Institute, a care research charity, have shown that up to four in five care home residents experience pain but are unable to communicate fully.
“People living with dementia might express pain through a distressed reaction or behaviour,” says Emma Hewat, director of dementia care at KYN. “It’s not ‘just’ their dementia — we have to understand triggers and causes of behaviour, including pain, which we can then manage.”
Traditionally, care staff have relied on a standardised printed checklist called the Abbey Pain Scale to assess pain levels. This asks the carer to mark the patient on a rising numeric scale across a series of observable signs, such as “vocalisation — eg whispering, groaning, crying” and “change in body language — eg fidgeting, rocking, guarding part of body, withdrawn”. But this was heavily subjective and often used ineffectively as a “tick-box exercise”, Hewat says. “I might look at you and decide you look like you’re in pain, but someone else might assess you differently.”
Staff also use PainChek at Loveday Abbey Road, a private members’ club-style nursing home in London with joining fees of £2,000 and care packages from £3,000 per week. The general manager, Izabela Klaczkiewicz, says PainChek minimises the risk of subjectivity because it always assesses residents by the same standards, regardless of which staff member uses it.
One of the people under her care is the former easyJet CEO Ray Webster, 78, who was diagnosed with Alzheimer’s in 2021 and moved into care from his home in Hampstead last autumn. His wife of 36 years, Brigitte Piroulas-Webster, 66, a retired business consultant, is delighted by his high-tech care. “I cared for Ray at home for four years and, from what I’ve experienced, if you ask him what the problem is, he can’t tell you. So anything that helps the carers understand what he needs is brilliant.”
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