Pain Assessment in Older Adults with Dementia: An Exploratory Pilot Study of Paramedic Students’ Perceptions of the Utility of Two Validated Assessment Tools

Abstract

Introduction This paper presents findings from an exploratory study in which undergraduate paramedic students’ trialled the use of two pain assessment tools as part of an interprofessional learning experience in residential aged care facilities. The research sought to identify the potential utility of the Abbey Pain Scale and PAINAD tools for use by paramedics with people with advanced dementia who have limited ability to communicate. Methods Thirty-one final year undergraduate paramedic students completed a 5-day clinical placement in in four residential aged care facilities in Tasmania, Australia. While on placement students used the two tools to assess pain in residents with known pain issues, under the supervision of nursing staff and paramedic tutors. A mixed methods approach, utilising a quantitative survey and a qualitative open-ended questionnaire, was adopted to ascertain students’ views on the potential for the tools to be used in paramedic practice. Results The research found both tools had potential for use in paramedic practice. Feedback from students indicated both pain assessment tools had strengths and weaknesses. Recommendations were made for how each of the tools could be adapted to make them suitable for use by paramedics. Conclusion Forecast increases in the number of people living with dementia, and the changing nature of paramedic practice, means that paramedics are more likely to be called on to assess pain in this population in community settings. Further research is needed to inform the development of pain assessment tools specifically for use by paramedics in these settings.