Measuring and addressing pain in people with limited communication skills: The “I hurt help me" pain management project.

Abstract

There are no national standards for pain assessment and treatment for people with Learning Disabilities or those who have limited communication skills. Residential homes are usually privately run with non NHS employees and there is a lack of training on pain and its management, with many staff unaware of basic treatment options. Following an audit within a range of Learning Disability Care Homes in a district in one county in the United Kingdom (UK) looking at pain assessment and management, a small feasibility study was carried out to ascertain which of three pain measurement tools were found to be most useful. DISDAT was identified as the tool of choice. A training package entitled “I Hurt Help Me” was developed for managers and carers working with people with a learning disability. The training consisted of how to assess pain using the DISDAT tool and pain management. The training sessions involved 203 carers in 54 residential homes, providing care for more than 287 residents. The evaluation of these sessions is presented here and demonstrates that carers’ pain assessment and management skills improved facilitating more individualised intervention. The standard of recording has improved and Health Action Plans (HAPs) are now becoming commonplace with detailed descriptors of individual residents - allowing a baseline to work from, enabling faster and more effective care for people with Learning Disabilities and the resultant reduction in challenging behaviour. The importance of training non-registered staff is highlighted and the need for further development in this area.