Dr. Thomas Hadjistavropoulos, University of Regina
Can you describe your area of research and how it is helping address a health-related issue in Saskatchewan?
Our research group is developing and disseminating methods aimed to better assess, recognize and manage pain in vulnerable older adults with dementia who live in long-term care environments.
Although very frequent, pain in older adults who have moderate to severe dementia is underrecognized and undertreated. This results in unnecessary suffering and reductions in quality of life. The undertreatment of pain in people with dementia is largely due to cognitive deficits, caused by dementia, that result in limited ability to communicate the subjective state of pain. Pain problems can produce challenging behaviours in this population. These challenging behaviours, caused by untreated pain, are often misattributed to psychiatric causes resulting in psychotropic rather than analgesic medication prescriptions. Psychotropic medications may hasten death in frail older adults.
What are the most rewarding aspects of your work?
Hearing from family members of older adults with dementia about ways our work has made a difference in their loved ones’ lives.
What is the most challenging aspect of your work?
While we have well validated, clinically useful and easy-to-use methods of better pain assessment, limited funding and resources prevent their wide scale implementation in the clinical front lines.
How did you first become interested in this area of research? What inspires you to do the work that you do?
I first became interested in better pain assessment in people who have dementia and limited ability to communicate verbally after learning about the work of one of my colleagues and mentors (Kenneth D. Craig) who developed better ways of evaluating pain in young infants who also have a limited ability to communicate verbally. The greatest motivator to keep going is recognition that we owe our oldest citizens the best possible long-term care that is not always available (as the COVID-19 pandemic revealed) due to resource constraints.
Where is your research headed in the next five years?
Technology development has the potential of overcoming some of the resource constraints associated with monitoring pain in people with limited ability to communicate. I expect that we will see developments in areas such as computer vision that will allow for the automated assessment of pain behaviours. This could help circumvent resource constraints in long-term care environments. In addition, we need many more studies focusing on implementation of existing clinical methodologies which are unavailable in the clinical front lines.
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