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The assessment of pain in older people: national guidelines
- Authors:
- ROYAL COLLEGE OF PHYSICIANS, BRITISH GERIATRICS SOCIETY, BRITISH PAIN SOCIETY
- Publisher:
- Royal College of Physicians
- Publication year:
- 2007
- Pagination:
- 13p.
- Place of publication:
- London
Pain is a subjective, personal experience, and its assessment is particularly challenging in the presence of severe cognitive impairment, communication difficulties or language and cultural barriers. As a result it is often under-recognised and under-treated in older people. These guidelines form part of a series intended to inform those aspects of physicians’ clinical practice which may be outside their own specialist area and are designed to help them make rapid, informed decisions. The advice is based on synthesis of the best available evidence and expert consensus gathered from practising clinicians and service users. The guidelines set out the key components of assessing pain in older people, together with a variety of practical scales that may be used with different groups, including those with cognitive or communication impairment. The purpose is to provide professionals with a set of practical skills to assess pain as the first step towards its effective management. The guidance is relevant to all healthcare and social care staff and can be applied in a wide variety of settings, including the older person’s own home, in care homes, and in hospital.
Guidance on: the assessment of pain in older people
- Authors:
- BRITISH PAIN SOCIETY, BRITISH GERIATRICS SOCIETY
- Publishers:
- British Pain Society, British Geriatrics Society
- Publication year:
- 2008
- Pagination:
- 36p.
- Place of publication:
- London
The British Pain Society has worked with the British Geriatrics Society and the Royal College of Physicians to produce new concise guidance on 'The assessment of pain in older people'. The guidelines have been developed to provide: recommendations in simple and clear terms for assessing pain in all older people; several types of scales that can be photocopied and used to assist in assessments, to monitor progress and evaluate the effect of treatment; and an algorithm for simple implementation of the guidance.
The assessment of pain in older people: UK national guidelines
- Author:
- SCHOFIELD Pat
- Journal article citation:
- Age and Ageing, 47(suppl 1), 2018, p.i1–i22.
- Publisher:
- Oxford University Press
This guidance highlights the problems in assessing and managing pain in an ever increasing older population. This brings an anticipated increase in the prevalence of chronic pain and with this comes the challenge of assessment of pain in many varied settings. The first iteration of this guideline was published in 2007. But there has been a proliferation of literature and research since then, so this is a a revised set of guidelines based on a systematic review to examine the evidence for the effectiveness of pain assessment strategies in older people with or without cognitive function. The objectives of the review included: exploring the attitudes and beliefs of older people with pain about the assessment of their pain and interactions with carers; evaluating the effectiveness of the assessment of function as a measure of pain in older people; evaluating the effectiveness of self-assessment to quantify pain in older people and determining if changes in pain assessment strategy are required for people with cognitive impairment, mental health or psychological problems. These guidelines provide a range of tools which demonstrate good validity and reliability for clinical practice in assessing pain in older people. (Original abstract)
The assessment of pain in older people
- Authors:
- ROYAL COLLEGE OF PHYSICIANS, BRITISH GERIATRICS SOCIETY, BRITISH PAIN SOCIETY
- Publisher:
- Royal College of Physicians
- Publication year:
- 2007
- Pagination:
- 13p.
- Place of publication:
- London
Pain is under-recognised and under-treated in older people, and the assessment of pain is particularly challenging in the presence of severe cognitive impairments, communication difficulties or language and cultural barriers. This guidance sets out the key components of assessing pain in older people, together with a range of practical scales that can be used with different groups, including those with cognitive or communication impairment. It aims to provide professionals with a set of practical skills to assess pain as the first step towards its effective management. It describes the background and methodology used, key components of an assessment of pain, and types of scale used to assess pain. It also provides a summary of recommendations in the full guidelines covering: pain awareness, pain enquiry, pain description, pain location and intensity, communication, assessment in people with impaired cognition/communication, cause of pain, and re-evaluation. It notes that the basic guidelines should be a routine part of the training and care provision of all healthcare professionals. The appendices include the guideline development process, an algorithm for the assessment of pain in older people, a pain map, and examples of pain scales.
Recognising and preventing delirium
- Authors:
- NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE, SOCIAL CARE INSTITUTE FOR EXCELLENCE
- Publishers:
- National Institute for Health and Care Excellence, Social Care Institute for Excellence
- Publication year:
- 2017
- Pagination:
- 4
- Place of publication:
- London
A quick guide to help care home managers and their staff to recognise the symptoms of delirium and to understand what they can do to prevent it. The guide covers: risk factors for delirium, recognising delirium, preventing delirium, and sharing information with the person and their family. The guide will be useful for staff training. (Edited publisher abstract)
Falls: assessment and prevention of falls in older people: CG161
- Author:
- NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE
- Publisher:
- National Institute for Health and Care Excellence
- Publication year:
- 2013
- Pagination:
- 315
- Place of publication:
- Manchester
Falls and fall-related injuries are a common and serious problem for older people. People aged 65 and older have the highest risk of falling, with 30% of people older than 65 and 50% of people older than 80 falling at least once a year. This clinical guideline is for healthcare and other professionals and staff who care for older people who are at risk of falling. It provides evidence and recommendations on the assessment and prevention of falls in older people. It extends and replaces ‘Falls: assessment and prevention of falls in older people’ (NICE clinical guideline 21; 2004), by including additional recommendations about preventing falls in people admitted to hospital (inpatients). This document includes all the recommendations, details of how they were developed, and summaries of the evidence they were based on. (Edited publisher abstract)
Falls in older people: assessing risk and prevention: CG161
- Author:
- NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE
- Publisher:
- National Institute for Health and Care Excellence
- Publication year:
- 2013
- Pagination:
- 33
- Place of publication:
- Manchester
This clinical guideline is for healthcare and other professionals and staff who care for older people who are at risk of falling. It extends and replaces NICE clinical guideline 21 (published November 2004). It offers evidence-based advice on preventing falls in older people; and also offers best practice advice on the care of older people who are at risk of falling. New recommendations have been added about assessing and preventing falls in older people during a hospital stay. All people aged 65+r are covered by all guideline recommendations. People aged 50 to 64 who are admitted to hospital and are judged by a clinician to be at higher risk of falling because of an underlying condition are also covered by the guideline recommendations about assessing and preventing falls in older people during a hospital stay. The full guideline, 'Falls: assessment and prevention of falls in older people' contains details of the methods and evidence used to develop the guideline; it was developed by the Internal Clinical Guidelines Programme at NICE. (Edited publisher abstract)
Quality care for older people with urgent and emergency care needs: the silver book
- Authors:
- BRITISH GERIATRICS SOCIETY, et al
- Publisher:
- British Geriatrics Society
- Publication year:
- 2012
- Pagination:
- 102p.
- Place of publication:
- London
Despite the majority of urgent care being delivered in the primary care setting, an increasing number of older people are attending emergency departments and accessing urgent care services. There is a pressing need to address how older people are cared for over the first 24 hours of an urgent care episode. The aim of this book is to address the care for older people, specifically frail older people, during the first 24 hours of an urgent care episode. It recommends ways in which emergency admissions can be reduced and the experience of those admitted improved. It considers all the clinical contacts which a patient might have during an emergency and suggests minimum standards and responses for each service. A core focus is the skills and competencies needed by healthcare staff to ensure they are better able to assess and manage frail older people. This includes: appropriate communication skills (both with patients and other health and social care professionals); clinical reasoning and assessment skills in respect of complex co-morbidities, poly-pharmacy and altered physiological response to trauma and illness; and risk management skills surrounding discharge planning with knowledge of community services. The book suggests that in acute medical units, greater use of geriatric liaison services should increase the proportion of older people able to be managed in community settings.
Key principles of person-centred dementia care: statement of best practice
- Author:
- NATIONAL CARE FORUM
- Publisher:
- National Care Forum
- Publication year:
- 2007
- Pagination:
- 5p.
- Place of publication:
- Coventry
People with dementia have the same rights as citizens. This includes the right to be treated with dignity and respect. Care and support services should build on individual strengths and abilities to maximise and promote independence. However, given the potential vulnerability of some people with dementia there is a need for a good understanding of adult protection requirements. This Statement of Best Practice has been prepared by the National Care Forum (NCF) Older People and Dementia Care Committee to specify indicators of quality in relation to person-centred dementia care services. It is not intended to be definitive or to provide detailed information on dementia. The Statement will be periodically updated. It is expected that a person-centred approach will be evidenced in the Statement of Purpose and Service User Guides produced by NCF members.
Clinical practice guideline for the assessment and prevention of falls in older people
- Author:
- NATIONAL COLLABORATING CENTRE FOR NURSING AND SUPPORTIVE CARE
- Publisher:
- Royal College of Nursing
- Publication year:
- 2004
- Pagination:
- 283p.
- Place of publication:
- London
This guideline for health professionals covers older people living in the community, either at home, in a retirement complex, or in a residential or nursing home. An older person is defined as someone who is aged 65 or over. The guideline does not cover people who are bed bound or who are in hospital for reasons other than treatment after a fall. The main areas examined by the guideline were: the evidence for factors that increase the risk of falling; the most effective methods of assessment and identification of older people at risk of falling; the most clinically and cost effective interventions and preventative strategies for the prevention of falls; the clinical effectiveness of hip protectors for the prevention of hip fracture; the most clinically and cost effective interventions and rehabilitation programmes for the prevention of further falls; and older peoples’ views and experiences of falls prevention strategies and programmes. Recommendations for good practice and cost effectiveness are presented. The guidance was commissioned by the National Institute for Clinical Excellence (NICE).