My Loved One in a Nursing Home Is in Pain

1. My Loved One in a NursingHome Is in Pain ltcpractice.com

2. Pain: Recognition • The resident reports pain to staff or family. • The staff notices a change in the resident. • The family notices a change in the resident. • The resident’s mental or functional state changes.

3. Pain: Types Chronic – present over six months Acute – chronic condition worsened or new pain producing condition

4. Pain: Causes of Chronic Pain • Arthritis • Osteoporosis • Nerve damage (from Diabetes or shingles) • Impaired circulation

5. Pain: Causes of Acute Pain • Broken bones • Bruises • Pressure ulcers • Shingles • Swelling • Dental problem

6. Pain: What makes it worse? • Depression and anxiety • Fear of pain (not leaving or returning again) • Immobility • Underreporting (unable to communicate) • Under treating (pain pills not effective and/or not given)

7. How will the doctor or nurse practitioner evaluate the pain? • Physical examination of the painful area • Evaluation of risks and likely causes • Review pain pills ordered and given • Change pain pills (dose or type) when not effective • Order other appropriate treatments • Periodic evaluations

8. How will the nursing home staff treat the pain? • Anticipate the pain • Evaluate changes in mental or functional state • Give pain pills as ordered • Monitor effect of medication • Notify MD/NP when pain not well managed

9. Pain: Treatment Options - A • Analgesics (by pills, suppository, injection, topicals) • Heat (by compresses, soaks, ,moisture) • Massage (by physical therapy, private massage)

10. Pain: Treatment Options - B • Other medications (to manage depression or anxiety or to increase effectiveness of analgesics) • Positioning (with pads, cushions, recliners) • Distractions (with activities, visitors, clergy) • TLC (reassurance, understanding, listening)

11. Pain: How can the family help? • Report your observations to the staff. • Notify staff of treatments that have worked. • Inform staff of treatments that have not worked. • Support your family member while an effective pain management program is implemented.

12. Pain: Things to remember! • Effective pain control is your loved one’s right and our goal. • Acute short term pain can usually be controlled. • Chronic pain is rarely eradicated completely. • Pain management, using a combination of treatments, often takes time to be fully effective.

13. Pain: Another consideration! If your loved one is in pain as part of a terminal condition the pain will be managed best when other symptoms are also well managed (i.e. nausea, vomiting, constipation, anxiety, fear, etc.)

14. Pain: A Final Thought • Pain is experienced and handled differently by every person. • Managing the pain requires teamwork, time and care. • Family involvement is very important to a successful pain management program.