Pain Assessment, Management, and Impact Among Older Adults in Assisted Living.
Barbara Resnick, Marie Boltz, Elizabeth Galik and 4 others
PMID 31080144WHAT IT FOUND
Among 260 assisted living residents, 20% had pain by either self-report or observation, and 42% of those with pain were untreated.
Observed pain was related to lower function, more agitation and resistance to care; pain medication was not related to these outcomes.
Key findings
01In 260 assisted living residents, 20% had pain on either the observational PAINAD or self-report VDS, and 22 of the 52 residents with pain (42%) were not receiving pain medication.
02Pain identified by the observational PAINAD scale was associated with agitation, function and resistiveness to care; pain reported on the VDS was associated only with function.
03Use of pain medication was not associated with function, agitation or resistiveness to care after controlling for age, gender, comorbidities and cognition.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The analysis included 260 residents, while 452 were screened and 175 refused; results may not represent residents who declined. Only 52 residents had pain by either measure, and 9 could not provide subjective pain report, so pain-specific findings are limited. Pain was measured once, during a brief 5-minute activity period, so pain at other times may have been missed. The study was cross-sectional, so it cannot show that pain caused lower function, agitation or resistiveness to care, or that medication changed outcomes. The PAINAD was developed for individuals with cognitive impairment but was used with some residents without evidence of cognitive impairment. The study did not know whether settings had in-house primary health care providers or 24-hour availability of nursing onsite. Facilities were from Maryland, Pennsylvania and Massachusetts, so regional or cultural differences may limit generalization. Non-pharmacological treatments and co-analgesics were not measured.
Declared interests
No author conflict-of-interest statement is provided in the supplied text; the article is labeled as NIH extramural research support.
The easy way to misread this
Do not conclude that treating pain will improve function, agitation or resistiveness to care. The study was observational, and pain medication use was not associated with these outcomes after controlling for age, gender, comorbidities and cognition.