Developing a tailored approach to facilitate the introduction of the DOTS pain assessment and management tool for people living with dementia in long term care settings.

   Faculty of Health and Life Sciences

This project is no longer listed on and may not be available.

Click here to search for PhD studentship opportunities
  Dr Deirdre Harkin  No more applications being accepted  Competition Funded PhD Project (Students Worldwide)

About the Project

Dementia is a term used to describe a broad set of symptoms a person may experience when their brain has been damaged by various diseases or conditions. Healthcare teams can find it challenging to deliver high quality care to older patients who have dementia, multiple co-morbidities, complex polypharmacy requirements, pain, and a reduced ability to communicate. In such circumstances pain and its subsequent management is given a low priority. Undertreated pain can lead to distress and agitation in the person with dementia. This also affects their families and adds costs to health services (Evans et al. 2015; Afonso-Argiles, 2020). Healthcare staff need a variety of skills and tools to support them to enhance pain management practices with older people with dementia (Harkin et al. 2022).

Harkin et al. (2022) have co-developed a novel, holistic tool (DOTS) that enables healthcare teams to adopt a consistent approach to pain management from admission to discharge, in acute care settings. Anecdotal evidence suggests that DOTS may also offer a practical approach that complements available guidance and offers staff the additional information needed to manage pain for the person with dementia in long terms healthcare settings (LTCS).

Aim: To co-produce a programme of learning and facilitate the introduction of the DOTS pain management tool in long term care settings (LTCS).


1.    To synthesise existing evidence (literature, policy, healthcare knowledge) relating to utilisation of pain assessment tools in LTCS.

2.    To determine the healthcare teams current levels of knowledge and attitudes towards pain assessment and management in patients with advanced dementia in LTCS.

3.    To identify the educational needs and co-design learning approaches that enable the healthcare team to effectively use the DOTS tool in practice.

4.     To make recommendations for practice, policy and research. 

Method: A Participatory Action Research approach will be used.

Medicine (26) Nursing & Health (27)


Afonso-Argiles J., Meyer G., Stephan A., Comas M., Wubker A., Leino-Kilpi H., Lethin C., Saks K., Soto-Martin M., Sutcliffe C., Verbeek H., Zabalegui A., Renom-Guiteras A., (2020) Emergency department and hospital admissions among people with dementia living at home or in nursing homes: results of the European Right Time Place Care project on their frequency, associated factors and costs. BMJ Geriatrics 5;20(1):453. doi: 10.1186/s12877-020-01835
Alzheimer’s Disease International (2023) Dementia Statistics Available at ( [Accessed on 28/03/2023]
Evans, S., Brooker, D., Thompson, R., Bray, J., Milosevic, S., Bruce, M. and Carter, C. (2015) Introduction to the transforming dementia care in hospitals series. Nursing Older People, 27(6), 18-24.
Freire, P. (1985) The politics of education: Culture, power, and liberation. Basingstoke: Greenwood Publishing Group.
Harkin, D., Coates, V. and Brown, D. (2022) Exploring ways to enhance pain management for older people with dementia in acute care settings using a Participatory Action Research approach. International Journal of Older People Nursing, 17, e12487
Reason, P. and Bradbury, H. (2014) Handbook of action research: Participative inquiry and practice. London: Sage.

 About the Project