Arrunga - UnitingCare NSW.ACT - Physiotherapy pain management program

Category: Personal, medical and clinical care

Arrunga – UnitingCare NSW.ACT, Ermington, NSW

The Physiotherapy Pain Management Program is an initiative within Arrunga aged care home. It involves an innovative non-pharmacological treatment approach of care. The program has been underway for over four years and a thorough analysis of the program has been undertaken.

The project looks at the overall effects of the various pain interventions used in managing chronic pain in the elderly with the view to demonstrate a benefit for residents in reduced and better managed pain and thus improved quality of life.

Physiotherapists attend the home and carry out the pain management clinic four days a week, treating painful areas with therapy modalities and interventions such as hydrocollator heat packs, massage, joint mobilisation and TENS (transcutaneous electrical nerve stimulation).

Physiotherapist assistants help by assisting residents to get to the pain clinic, assisting with resident positioning, and preparation and application of heat packs.

Some residents who are unable to visit the pain clinic are attended to in their rooms. Every month, the facility management and the physiotherapist meet to review the pain program in detail. During this time, the residents’ pain is discussed and the program is re-evaluated.

The residents attend the pain clinic and are treated as a group receiving heat packs while the physiotherapist attends to the residents with interventions, ensuring privacy and dignity. This social approach an additional positive effect, allowing for interaction with other residents and opens up discussions for various ways of dealing with pain.

Data was collected over eight areas including analgesia usage, reported pain levels and activities of daily living such as activity, sleep and mobility.

1.       Change in dosage/frequency of medication
2.       Change in type of medication according to WHO analgesic ladder
3.       Change in pain score/level
4.       How pain affects sleep
5.       How pain affects general activity level
6.       How pain affects mobility
7.       How long pain returns after taking medication
8.       How has medication or interventions relieved pain in the past week

This data has been collected from residents’ assessments and charts and are then re-evaluated using their most recent documentation (six to nine months later). The use of analgesia was then analysed against the WHO (World Health Organization) analgesic ladder to reflect the movements of a treatment plan over six to nine months for controlling pain.

Most (85%) of the residents on the program have improved or maintained their pain status over time. With both the sensation (through medication) and the source of the pain (through physiotherapy interventions) being addressed, the residents receive positive outcomes and improved quality of life.

Across all eight areas, 11% of residents improved, 74% maintained and 15% regressed. All 40 residents on the program report subjective improvements, in particular coping better with their day and enjoying the therapy interventions.

For more information on this program, contact Celedonia Laverty, email: claverty@unitingcarenswact.org.au or phone: (02) 8878 6481, or Sri Mattapalli, email: smattapalli@unitingcarenswact.org.au phone: (02) 8878 6492.

www.unitingcarenswact.org.au