Can we improve pain management in nursing homes?

Melding, Pamela S

doi:10.5694/j.1326-5377.2002.tb04610.x

Topics

No one, least of all nursing-home staff, likes to see people in pain

Most older people, despite limitations, live happy and active lives. Only a small proportion of them — those with major disabilities and complex medical needs — spend their final days in nursing homes. While these residential facilities may aspire to provide quality care for their residents, there are important gaps. As McClean and Higginbotham point out in this issue of the Journal (page 17),1 one such deficiency is in recognising and managing chronic pain.

Division of Psychiatry and Behavioural Science, Faculty of Medicine and Health Science, University of Auckland, Auckland, New Zealand.

Correspondence: p.melding@auckland.ac.nz

Competing interests:

None declared.

1. McLean WJ, Higginbotham NH. Prevalence of pain among nursing home residents in rural New South Wales. Med J Aust 2002; 177: 17-20. <eMJA full text>
2. Jacobzone S. Coping with aging: international challenges. What are the implications of greater longevity and declining disability levels? Health Aff (Millwood) 2000; 19: 213-225.
3. Williamson GM, Schulz R. Pain, activity restriction and symptoms of depression among community-residing elderly adults. J Gerontol 1992; 46: 367-372.
4. Parmelee PA. Pain and psychological function in late life. In: Mostofsky DI, Lomrantz J, editors. Handbook of pain and aging. New York: Plenum Press, 1997: 207-226. (Plenum Series in Adult Development and Aging.)
5. The standards and guidelines for residential aged care services manual. Canberra: Aged and Community Care Division, Commonwealth Department of Health and Aged Care, 1998. Available at: <http://www.health.gov.au/acc/manuals/sgr/sgrindex.htm>. Accessed 3 June 2002.
6. McCaffery M, Ferrell BR. Nurses' knowledge of pain assessment and management: how much progress have we made? J Pain Symptom Manage 1997; 14: 175-188.
7. Barclay S, Todd C, Grande G, Lipscombe J. How common is medical training in palliative care? A postal survey of general practitioners. Br J Gen Pract 1997; 47: 800-804.
8. Sengstaken EA, King SA. The problems of pain and its detection among geriatric nursing home residents. J Am Geriatr Soc 1993; 41: 541-544.
9. Cohen-Mansfield J, Creedon M. Nursing staff members' perceptions of pain indicators in persons with severe dementia. Clin J Pain 2001; 18: 64-73.
10. Leventhal EA, Prohaska TR. Age, symptom interpretation and health behaviour. J Am Geriatr Soc 1986; 34: 183-191.
11. Gloth FM III. Geriatric pain. Factors that limit pain relief and increase complications. Geriatrics 2000; 55: 46-54.
12. Buffum MD, Miaskowski C, Sands L, Brod M. A pilot study of the relationship between discomfort and agitation in patients with dementia. Geriatr Nurs 2001; 22: 80-85.
13. Kovach CR, Weissman DE, Griffie J, et al. Assessment and treatment of discomfort for people with late-stage dementia. J Pain Symptom Manage 1999; 18: 412-419.
14. Bannwarth B, Pehourcq F, Lagrange F, et al. Single and multiple dose pharmacokinetics of acetaminophen (paracetamol) in polymedicated very old patients with rheumatic pain. J Rheumatol 2001; 28: 182-184.

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