Pain Management

While persistent pain may be common in older adults, it is not a normal part of the aging process. Most nursing home residents have at least one condition associated with pain, with pain prevalence estimated to be as high as 55 percent. Persistent pain, or insufficient treatment for pain, can lead to adverse outcomes including depression, sleep disturbances, changes in appetite, falls and an increase in functional impairment.

Successful pain management programs include processes for completing comprehensive pain assessments, along with re-evaluations to determine the treatment’s effectiveness. Standardized, evidence-based assessment tools are an important component of any pain management program. A variety of valid and reliable assessment tools are available, including tools developed specifically for evaluating residents with dementia or other cognitive impairments. Each resident should have a comprehensive pain assessment completed on admission, quarterly thereafter and whenever there are changes in condition. The comprehensive pain assessment serves as the baseline from which care planning will be initiated and measurable goals established.

Care planning is an ongoing inter-disciplinary process that is initiated at the time of admission. Interventions should be based on identified factors from the pain assessment process, with measurable goals that address the resident’s preferences, expectations and needs. The effectiveness of the interventions should be evaluated periodically, and the care plan revised as necessary to reflect changes in the pain assessment. The goal for pain management and the best possible outcome is the relief and control of pain.

The toolkit below includes evidence-based resources that will assist facility staff in developing effective systems for pain management.

Resources Created by HHS

Resources from Other Organizations

Clinical Practice Guidelines and Resources

Bibliography