Pain assessment in older adults with dementia: An exploratory pilot study of paramedic students’ perceptions of the utility of two validated assessment tools

Introduction: TThis paper presents findings from an exploratory pilot study in which undergraduate paramedic students trialled the use of two pain assessment tools as part of an interprofessional learning activity in residential aged care facilities (RACFs). The research sought to gain students’ perceptions of 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 four RACFs in Tasmania, Australia. While on placement, students used the two clinically validated pain assessment 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’ perceptions about the potential for the tools to be used in paramedic practice.

Results: The research found that students considered both tools had potential for use in paramedic practice. Feedback from this cohort of students indicated they considered the Abbey Pain Scale was more useful for assessing pain in cognitively impaired older people, although students reported they considered the PAINAD Scale to be more relevant to their future role as paramedics. Recommendations were made by the students for how each of the tools might be adapted to make them more suitable for use by paramedics.

Conclusion: Forecast increases in the number of people living with dementia, and the changing nature of paramedic practice in the 21st century, 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.