Pain assessment in severe demented elderly based on facial expression

Introduction: Pain is an important and underestimated aspect at elderly with dementia, especially when their communication skills deteriorate. Moreover, the risk of under treatment increases with the progression of dementia, despite of the increasing pharmacological possibilities and interest in pain. Facial expression can be considered as a reflection of the real, authentic pain experience. Elderly with cognitive limitations are less socially inhibited to express pain nonverbally. Therefore observation of facial expression seems an interesting pain indicator for nurses, leading to a more accurate pain assessment, which is a must for this group of patients. Methods and Materials: The PAINVISION-project is a pilot study to set up a low-cost vision system that can continually identify pain in real-time by means of facial pattern recognition techniques. This study took place in a specific geriatric centre, and was approved by a medical ethical committee. Nineteen bedridden demented elderly with limited ability to communicate directly, were included. In six assessment sessions images of the patient’s face were recorded by a new bedside two-camera system, linked to pain scores of a digital device (a tablet PC with a touch screen). Results: At the moment, further data collection and processing is carried out to identify the most specific facial pain indicators. All results would be available in May 2010. Conclusion: If indeed specific facial expressions contain sufficient pain information for the observer, a short and thus time efficient observational pain scale can be developed for patients who cannot express their pain verbally anymore. These findings hopefully stimulate nurses to perform more frequent pain measurements on patients with limited ability to communicate to increase the accuracy of the pain evolution. A more adequate treatment can be provided with the knowledge of a more accurate pain level, and thus improving quality of life.status: publishe

Expertisecentrum Val- en fractuurpreventie Vlaanderen (EVV): Jaarrapport 2014. In opdracht van het Ministerie van de Vlaamse Gemeenschap, Afdeling Welzijnszorg

status: publishe

Flanders’ falls awareness week: An example of promoting fall prevention strategies within the community and residential care settings

Introduction: Falls in older persons are common and may lead to serious consequences (e.g. fractures, fear of falling, economic burden). Ample evidence is available about effective fall prevention (FP) strategies, but implementation in routine practice remains problematic. Methods: The Center of Expertise for Falls & fracture Prevention (Expertisecentrum Val- en fractuurpreventie Vlaanderen) aims to improve FP by addressing local needs, barriers to and facilitators of implementing effective strategies. By means of an annual falls awareness week (FAW), anyone working with older persons co-operates to deliver a similar message; e.g. “Stay active, avoid falling!”. The overall objective of the FAW 2013 is to encourage older people to stay fit and physically active as long as possible. Participating organizations are provided with a wide range of evidence based materials, activities and resources to promote physical activity and FP (e.g. leaflets, an activity pyramid, advanced exercise programs, “Lifelong dancing”-parties, etc.). Results: As a result, 769 organizations in Flanders participated during the FAW 2013. More specifically, 244 home care organizations, 360 residential care facilities, 61 hospitals and 104 other organizations organized their own FAW event. Conclusions: The FAW can be considered a valuable strategy to promote FP within the community and residential care. By focusing on the positive effects of mobility rather than on the negative effects of immobilization, Flemish older persons are stimulated to stay active, hereby reducing their fall risk.status: publishe

Actief blijven, de preventie

Valpreventie ‘staat of valt’ met de actieve medewerking van ouderen en zorgverleners. Actief blijven, houdt de oudere fit en vermindert de kans op vallen. En de uitdaging voor de thuisverpleegkundige? Die ligt vooral in het actief blijven zoeken naar ‘effectieve’ valpreventiemaatregelen.no issnstatus: publishe

Expertisecentrum Val- en fractuurpreventie Vlaanderen (EVV): Jaarrapport 2015. In opdracht van het Ministerie van de Vlaamse Gemeenschap, Afdeling Welzijnszorg

status: publishe

Expertisecentrum Val- en fractuurpreventie Vlaanderen (EVV): Jaarrapport 2013. In opdracht van het Ministerie van de Vlaamse Gemeenschap, Afdeling Welzijnszorg

status: Published onlin

Expertisecentrum Val- en fractuurpreventie Vlaanderen (EVV): Jaarrapport 2016. In opdracht van het Ministerie van de Vlaamse Gemeenschap, Afdeling Welzijnszorg

status: Published onlin

Expertisecentrum Val- en fractuurpreventie Vlaanderen (EVV): Jaarrapport 2017. In opdracht van het Ministerie van de Vlaamse Gemeenschap, Afdeling Welzijnszorg

status: Published onlin

Predicting falls in nursing homes: accuracy of screening methods in a prospective multicenter cohort study with six months follow-up

status: Published onlin