Improving Quality
and Financial Results

primaris flame Tip 5: Assessing pain in patients

Caregivers play a key role in the support and treatment of persons in pain. Assessing pain is the first step to helping.  There are many tools that can be used by residents to rate pain.  Ask what works best for each resident and use that same pain scale all of the time.  Choices may include:

  • Numeric rating scale
  • Pain thermometer
  • Verbal descriptor scale
  • Wong-Baker faces scale

Some residents have problems thinking clearly and can not use scales.  Staff may use facial or eye cues to detect pain and pain relief for these residents. There are also special pain tools for staff to use.  These include:

  • PAINAD (Pain Assessment in Advanced Dementia)
  • PADE (Pain Assessment for the Dementing Elderly)

Working in a nursing home gives staff the chance to get to know their resident’s usual behavior and daily habits.  Sometimes pain can be noticed by checking other things. Pain may cause:

  • Weight loss
  • Less movement
  • Falls
  • Decrease in ADLs 
  • Trouble sleeping
  • Changes in mood or actions

Treatment tips for caregivers:

  • Ask for family input to help with detection of pain in their loved one.  Relatives can provide past reasons for pain as well.
  • The best way to control persistent pain is for the resident to receive medication on a regular basis.
  • If you know that a certain activity causes pain, make sure the resident gets medication beforehand.

Use a variety of non-medication therapies such as:

  • Distraction
  • Music
  • Repositioning
  • Emotional support
  • Massage
  • Humor and laughter
  • Calming statements
  • Exercise
  • Story telling
  • Heat and/or cold therapy

You can make a difference in helping your residents have better pain control.  Most importantly, pain relief will improve their quality of life.

References:
Littlehale, S., Niemi, J., & Capitosti, S. (2007). Improving pain management. Provider, 33(10), 55-56, 59-60.  Mentes, C., Teer, J., & Cadogan, M. (2004). The pain experience of cognitively impaired nursing home residents: Perceptions of family members and certified nursing assistants. Pain Management Nursing, 5(3), 118-125.