None listed
Conditions
Brief summary
Untreated pain in people with dementia is a critical public health problem. Up to 80% of people living in residential aged care facilities (RACFs) are affected by pain and half of them are diagnosed with dementia. As a result of the progressive cognitive decline associated with dementia, they may have limited ability to verbalise their pain experience. Despite the high prevalence of pain among this group, it becomes increasingly difficult to accurately assess and manage pain in people with dementia. Undertreatment of pain is associated with low quality of life and high healthcare costs. Given these negative impacts of untreated pain in people with dementia, the imperative for research is to identify innovative pain assessment tools and cost-effective interventions to adequately manage pain in this vulnerable population. Notably, our pilot study with a daily 15-minute session of a social robot (PARO robotic seal) intervention has shown significantly reduced observational pain levels and as-needed medication use in people with dementia living in RACFs. Participants found a 4-week PARO intervention acceptable and also reported benefits on improvement in mood, sleep quality and pain relief. However, little is known about the cost-effectiveness of the PARO intervention on pain management, especially in people with dementia living in RACFs, making this an area worthy of study. This study aims to evaluate the effectiveness and economic value of technologies (the PainChek app and PARO robotic seal) on pain management in residential aged care, particularly for people with dementia. Findings from this novel project will develop essential guidelines for the use of technologies to support pain management in dementia care. This will contribute significantly to the improvement of care and quality of life in people with dementia, and potentially reduce treatment costs. It will produce high-quality publications in peer-reviewed journals and presentations at national/international conferences, leading to future national competitive fellowships and grant applications.
Interventions
The PersonAl RObot (PARO) is a therapeutic robot and a non-pharmacological intervention for people with dementia. PARO has the appearance of a baby harp seal and is covered with artificial fur, which is soft and warm to touch. It has the following four senses: sight, hearing, balance and tactile senses. PARO has two optical nose sensors to recognise the source of light and has a diurnal rhythm of sleep or movement according to the light sources and stimulation of the sensors. PARO also has three
The PersonAl RObot (PARO) is a therapeutic robot and a non-pharmacological intervention for people with dementia. PARO has the appearance of a baby harp seal and is covered with artificial fur, which is soft and warm to touch. It has the following four senses: sight, hearing, balance and tactile senses. PARO has two optical nose sensors to recognise the source of light and has a diurnal rhythm of sleep or movement according to the light sources and stimulation of the sensors. PARO also has three microphones in its ears to detect sound source direction and speech recognition, such as its name or greetings, as well as some simple words. It contains a posture sensor to maintain balance and recognises its posture when it is held by a user. For motion, it has seven silent intelligent actuators to open and close its eyes and move its neck and its front and rear flippers. Thus PARO combines these four senses to respond and communicate with users by moving or making a sound. The voice of PARO was recorded from a real baby harp seal. PARO can also learn users’ preference for its behaviour and has emotions such as happiness or anger. In this study, participants living in residential aged care facilities randomised to Intervention Group will receive a 15-minute non-facilitated individual (one-on-one) PARO intervention per day from Monday to Friday for four weeks and we will follow up at week 8. In each session, trained research assistants (RAs) will introduce PARO to a participant and leave the robot to the participant for 15 minutes. RAs will record the time, duration and interactions of participants with PARO for each session using an observation diary. Before and after each session, trained research assistants (RAs) will assess the pain levels of participants using the PainChek app during the four-week intervention. The RA will use a Tablet camera to capture a three-second video of the facial expressions of participants. The facial indicators of pain will be detected automatically and the RA will record other pain-related behaviours such as voice, movement, behaviour, activity and body language via the PainChek app. It takes around two minutes to complete the assessment.
Sponsors
Griffith University
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Subject, Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
(1) Age 65 years and older and can speak and understand English. (2) Participants must have been diagnosed with some form of dementia. (3) Participants are assumed to experience chronic pain if they report and have regular pain medication. (4) Demonstration of sensation and perception to allow interaction with PARO. (5) Living in the care facility for more than 3 months.
Exclusion criteria
(1) Diseases such as acute exacerbation of chronic obstructive pulmonary disease that requires residents to be admitted to hospital frequently; (2) Terminal illnesses where the resident is in the final palliative stage; (3) A diagnosis of a major mental illness, such as schizophrenia; (4) A diagnosis of Parkinson’s Disease as their facial features could have been compromised due to the nature and progress of the condition; and (5) Infectious diseases, such as acquired immune deficiency syndrome, COVID-19, or tuberculosis, or an open wound that is unable to be covered.
Outcome results
None listed