September TCAID: In Focus - Healthcare Staff Experience of Supporting Older Adults with Intellectual Disability who are in pain: A systematic review.
Louise O Reilly
Clinical Nurse Specialist - Health Promotion
RNID, BSc Nursing, MSc AHWID, PgCert.
Having practiced as a Registered Nurse in Intellectual Disabilities (RNID) for 28 years supporting people with intellectual disabilities, Louise is currently in the role of Clinical Nurse Specialist in Health Promotion in Stewarts Care. Louise has a keen interest in supporting healthy ageing for people with intellectual disability ensuring her work is informed by latest evidence of determinants of health across the lifespan in relation to breast cancer awareness and also collaborating with theme lead members of the Trinity Centre of Ageing and Intellectual Disability on projects and campaigns relating to oral health, brain health, bone health and frailty.
Supported by supervisors Dr Eilish Burke and Mr Paul Keenan, Louise completed her MSc in Ageing Health & Wellbeing in Intellectual Disability in Trinity College Dublin in 2022 and delivered an oral presentation on her dissertation on Healthcare Staffs Experiences of Supporting Older Adults with an Intellectual Disability who are in Pain – A Systematic Review at the Trinity Health & Education international Research conference 2023.
Thematic analysis method was employed and four themes emerged. Barriers to effective pain recognition including poor awareness and scepticism of pain prevalence, diagnostic overshadowing, and the belief in the myth people with intellectual disability have a high pain threshold. Pain was identified through observation of physical movements, facial expressions and behavioural indicators. There was poor evidence of the use of pain assessment tools or pain management protocols and although self-report of pain is the gold standard, there was an overreliance on verbal communication of pain.
Recommendations from this research call for the establishment of protocols and practice pathways to guide assessment and management of pain, the education and training of healthcare staff who support people with intellectual disabilities including non-specialist and acute services. We must also ensure healthcare staff participate in scaffolding the communication skills of the older adult, building capacity to self-report the presence of pain.
Louise has continued to disseminate this research at conferences including the Nurse Midwifery Practice Development - Dublin South, Kildare Wicklow Annual Nursing & Midwifery Regional Conference, where her poster presenting her dissertation won 2nd prize.