Pain Assessment and Management Among Nursing Home Residents Living With Dementia.
Barbara Resnick, Elizabeth Galik, Rachel McPherson and 3 others
PMID 40360333WHAT IT FOUND
In nursing home residents with dementia, 74% had pain assessed with the wrong tool, and only three assessments used an observation tool appropriately.
Pain was rarely recorded, but that may reflect poor assessment rather than good control.
Key findings
01The appropriate pain assessment tool was not used for 74% of residents; 31 verbal assessments and only 3 observational assessments were done appropriately.
02Pain was rarely recorded: 88% had no pain on the Minimum Data Set verbal tool, 97% on the Minimum Data Set observation measure, and 90% on the PAINAD.
03Pain care plans were usually generic, and opioid documentation was poor: 93% had pain addressed but only 9% were individualized, and the mean opioid appropriateness score was 2.9 of 10 items.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 93 residents from four nursing homes were included, so the findings may not apply to other communities. Minimum Data Set chart assessments were done at variable times, from less than one month to five months before the research observation, so the pain measures were not compared at the same time. Nonpharmacologic treatments may have been used but not documented. The sample was mostly female, white, non-Hispanic, and had at least high school education. This was a baseline descriptive study, not a test of whether better assessment or documentation improves pain control.
Declared interests
The authors declared no competing financial interests or personal relationships. The article is marked as supported by NIH extramural funding.
The easy way to misread this
Do not conclude that pain is absent or well controlled because most residents had no pain recorded. The study found that 74% of pain assessments used the wrong tool for the resident's ability to report pain, and the three pain measures were not related to one another.