Royal Star & Garter - High Wycombe's pain management journey

1​3 May 2025

High Wycombe enhances quality of care for residents with diverse needs

Royal Star & Garter provides care for veterans and their partners, who live with disability or dementia, in three state-of-the-art homes. High Wycombe in northwest London is its newest home. Designed for the comfort and wellbeing of its residents, the home offers specialist nursing and dementia care in a relaxed environment.

Recognising the importance of tailored pain management strategies, particularly for those living with dementia or disability, and unable to reliably self-report their pain, High Wycombe introduced PainChek^® to the home.

Resident case study 1: “CC”

Background

CC is a 62-year-old gentleman who moved to the service as he has high nursing needs due to several chronic conditions, including a coronary artery bypass graft, heart failure, Type 1 diabetes, fractures due to falls, emphysema and depression. He also requires dialysis three times per week following a kidney transplant. Due to his fractures, CC’s mobility was significantly reduced. His chronic pain severely impacted his quality of life, leading to depression, anxiety, and use of Oxycodone. His ability to reliably self-report his pain also fluctuated.

Pain journey

• Initial assessment: The resident was taking a high dose of strong pain relief medication and when the resident self-reported his pain, it was often moderate to severe.
• Use of PainChek: As CC’s ability to reliably self-report his pain fluctuated, PainChek^® was used to identify and quantify his pain levels. On occasion, it was observed that his pain levels were mild and the analgesia he was taking was too strong for his condition.
• Intervention: The resident received regular visits from the GP and his pain relief medication was reviewed. Multidisciplinary teams were involved to support him with his depression and anxiety linked to his poor mobility and chronic conditions. Antidepressant medication was prescribed, and improvements were noted, with the resident enjoying one-to-one conversations with staff.

Outcomes

• Pain support: The PainChek^® tool provided the High Wycombe team with accurate pain data that prompted them to look at other underlying conditions such as depression and anxiety. With the right emotional support and good pain management, the resident’s level of pain decreased to NRS 1 and NRS 2.
• Improved quality of life: The resident purchased an electric wheelchair to maintain his independence and received regular visits from the in-house physiotherapist. It was also observed that the resident became more motivated to go out and was interacting more with others.
• Ongoing management: Further reviews of pain relief medication and further reductions in doses were made in conjunction with the resident’s increased wellbeing, demonstrating the positive impact of the administration of more appropriate medication.

In this instance, the resident was struggling with depression and found comfort in the strong analgesia he had available. However, the team at High Wycombe utilised PainChek to objectively assess his condition and found the pain wasn’t as severe as he was reporting. By assessing this way, they managed the pain in a more suitable way, but enhanced this gentleman’s life by better equipping him to be independent so he can enjoy meaningful activities and supported him with antidepressants. This example shows how PainChek has better supported a care provider to treat the root cause, and not the symptom.