The following resource is designed to assist Long-Term Care (LTC) homes with the implementation of the Assessment and Management of Pain Best Practice Guideline 3rd ed.. Documents found in this resource are evidence-based, but it is not a program plan. Each LTC home is unique and each home is in various stages of guideline implementation. LTC homes are advised to use the resource at their discretion. For those resources that have copyright notations, it is recommended that LTC homes obtain permission from the primary author prior to implementing them within their setting. The Toolkit is a dynamic resource, and is being updated and revised on a regular basis by the LTC Best Practices Program team. Visit this site often to see what's new!
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Symptom Management Algorithm for pain in adults with cancer developed by Cancer Care Ontario.
Cancer Care Ontario (2018) Symptom Management Algorithm- Pain in Adults with Cancer retrieved from https://www.cancercareontario.ca/en/symptom-management
Health HQ Neuropathic Pain Resources - This website provides access to resources related to neuropathic pain.
On April 11, 2023, changes to Ontario Regulation 246/22 (the "Regulation") under the Fixing Long-Term Care Act, 2021 (the "Act") came into effect.
Informed by engagement with key partners and stakeholders, as well as feedback from the public, the Ministry of Long-Term Care (the "Ministry") has refined the regulatory framework with consideration of the lived experience of residents and long-term care homes and emerging needs in the sector.
Retrieved from: https://www.ontario.ca/laws/regulation/220246
A pain rating scale used to determine a persons level of pain.
Reference: McCaffery, M., Beebe, A., et al. (1989). Pain: Clinical manual for nursing practice, Mosby St. Louis, MO
This resource from Interior Health, is a pain assessment tool useful for scoring pain levels of people with dementia who are unable to verbally express their pain. It focuses on assessing behaviours and provides a score rating of mild, moderate or severe pain levels.
Retrieved from: https://www.interiorhealth.ca/sites/default/files/PDFS/810310-pain-assessment-advance-dementia-scale.pdf
Warden, V., Hurley, A. & Volicer. L. (2003). Development and psychometric evaluation of the pain assessment in advanced dementia (PAINAD) scale. JAMDA, 4(1), 9 -15. Horgas, A., & Miller, L. (2008). Pain assessment in people with dementia. American Journal of Nursing, 108(7), 62-70.
The Opiod Manager condenses key elements from the Canadian Opiate Guideline into a workable format for prescribing opiates for persons with chronic, non-cancer pain.
Reference: National Opiod Use Guidelines Group (2010), Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain Practice Toolkit, Opioid Manager. Retrieved from http://nationalpaincentre.mcmaster.ca/opioidmanager/
© 2016 McMaster University
You may need to seek assistance from a health-care professional when you have concerns about people you care for who are in pain. Uncontrolled pain is a common problem. Pain can affect anyone at any age and include people who are unable to communicate that they are experiencing some form of pain. If people have pain during their day-to-day activities or during any medical procedure, this can affect the way they behave and function. This behaviour may cause you to feel helpless and distressed, especially if you can not help them with their pain and they are not able to speak for themselves.
Retrieved from: http://rnao.ca/bpg/guidelines/fact-sheets/helping-people-manage-their-pain
The Abbey Pain Scale is an instrument designed to assist in the assessment of pain in patients who are unable to clearly articulate their needs, for example, patients with dementia, cognition or communication issues. The scale does not differentiate between distress and pain, so measuring the effectiveness of pain-relieving interventions is essential.
Abbey, J; De Bellis, A; Piller, N; Esterman, A; Giles, L; Parker, D and Lowcay, B. Funded by the JH & JD Gunn Medical Research Foundation 1998 – 2002. This document may be reproduced with this acknowledgment retained.
https://www.apsoc.org.au/PDF/Publications/Abbey_Pain_Scale.pdf
The revised ESAS-r is available in multiple languages. The link will take you to the guidelines for using the ESAS-r tool. The ESAS-r tool is freely available to use, with appropriate acknowledgement of its source.
Website: http://www.palliative.org
This link takes you to PARC which supports, educates and informs persons with Reflex Sympathetic Dystrophy (RSD), otherwise known as Complex Regional Pain Syndrome (CRPS) the community and the medical professionals treating RSD, about the importance of early diagnosis and treatment.
