Looking at the Link between Pain and Aggression

As a physiotherapist with many years’ experience in continuing care, Camille Poulin knows how distressing aggressive behaviour in people with dementia can be. It can also be dangerous for caregivers. So when Camille, who currently works for Aspen Regional Health as InterRAI Project Lead, identified potential topics for her SEARCH V project, investigating the link between aggression and pain was a top-rated choice – not only by her but also by her colleagues. “It’s a common client concern for rehabilitation and nursing staff,” she says.

“We knew the results would be significant to the multidisciplinary teams that look after people with dementia.”

Camille conducted a review of the research literature, including clinical practice guidelines and Canadian theses. “The evidence supports the existence of a relationship between pain and aggression in late-stage dementia,” she says. “Furthermore, late-stage dementia pain and aggression symptoms respond favourably to analgesics. When multidisciplinary care teams address residents’ pain, they also decrease aggressive behaviours.”

Her findings have been disseminated widely to continuing care facilities in Aspen Regional Health and shared throughout the SEARCH network. As a result of the research, language around pain has been added to Aspen’s aggression policy for continuing care residents. Aspen also recently completed a search for pain assessment instruments to be used in its continuing care centres. The incorporation of pain assessments has the potential to decrease the incidence of aggressive behaviours, thereby improving the quality of life for residents and the safety of caregivers.