Shot of a senior man visiting his wife in hospital

The final stages of life are a difficult and emotional time, both for aged care residents and their loved ones.

The challenges associated with palliative care support are highly unique, as caregivers try to make residents as comfortable as possible while also trying to provide family members with peace of mind. Accurate pain assessment and management is critical during this time, in order to ensure residents live their final days with the highest quality of life in palliative care possible and reassure family members that their loved ones aren’t in pain.

Understanding the current challenges of pain management in palliative care

More than 50% of residents in Australian residential aged care facilities have dementia. These residents struggle to communicate their pain levels, and this challenge is only exacerbated as their condition deteriorates.

As a resident enters the late stages of dementia and Alzheimer’s disease, most cannot communicate directly or verbalise basic requirements — making it difficult for carers and caregivers to provide the best care possible. Those with the condition also suffer from discomfort and chronic pain.

Pain management in palliative care is critical to ensure residents can make the most of the time they have left. This requires frequent monitoring and assessment of a resident’s non-verbal signals, as slight behavioural changes may indicate that needs aren’t being met. However, these changes can be subtle and difficult for carers to detect, particularly if they are not familiar with the resident.

Community attitudes towards end-of-life care have also been shifting in recent years, with a greater focus on consumer-directed care and advance care directive. This presents aged care facilities with complex policy and practice challenges. Aged care providers need to consider advanced care directives, end-of-life care plans, and the interpretation of resident and family views on what constitutes “a good death” for their loved ones.

During this time, relatives also want to be assured that their loved ones aren’t suffering and can pass peacefully. Many cannot physically be there with their relatives — or communicate with them if they are — which makes it difficult to truly know whether their loved one is in pain.

These challenges have only been exacerbated by COVID-19. Social distancing measures have made it more difficult to assess pain and detect subtle non-verbal signals. At the same time, relatives have been unable to physically be by their loved one’s side during their final moments.

PainChek: a valuable tool for palliative care and pain management at the end of life

PainChek uses artificial intelligence and facial recognition to provide accurate pain assessment and support carers during the palliative care phase. PainChek has been clinically proven to offer significant advantages over other pain assessment methods.

Using a smartphone camera, carers record an individual’s face and PainChek uses facial recognition to automatically detect muscle movements that indicate pain. After this, carers are then guided through a questionnaire to assess pain using a number of indicators, including vocalisation, movement, physical changes, behavioural changes, and changes in activity. The app then gives carers an overall pain score, which can be used to guide pain management and treatment methods.

Learn more about how PainChek works in this video


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For many residential aged care providers, PainChek has proven invaluable for care staff during the palliative care phase. Villa Maria Catholic Homes (VMCH) began using PainChek in 2019. Since then, the app has empowered carers with end-of-life care tools and allowed them to have a targeted approach for palliative care pain management.

According to Jeffrey Brooks, PainChek’s Clinical Specialist and the former Clinical Manager of VMCH:

“We had an elderly man who was exhibiting escalating behaviours. He was non-verbal, had a diagnosis of dementia and was also receiving palliative care services. Through thorough PainChek assessments, staff were able to minimise his pain symptoms, and the behaviours settled. Having a TGA cleared-medical device allows staff to monitor residents across the whole of their medical journey, including in the palliative approach.”

Offering emotional support in palliative care for relatives

In addition to supporting carers with the tools to accurately assess and monitor pain treatment, PainChek provides relatives with greater peace of mind in knowing their loved ones are receiving the care they require.

PainChek automatically and securely stores pain assessments in the cloud for chronological monitoring. Using PainChek’s portal, carers can quickly and easily provide family members with information regarding their loved one’s historical pain levels and chart the effectiveness of treatments over time.

Register now for a free 12-month subscription to PainChek

The Federal Government is supporting a national roll-out of PainChek in Australian residential aged care providers for residents living with dementia or cognitive impairment. This initiative will allow more facilities to deliver accurate, timely care for residents during the palliative care phase, whilst alleviating family members’ concerns.