Ask Nursing Home Residents about Pain and Observe Non-verbal Clues

Pain management for nursing home residents is shifting toward more holistic care, according to the March 2023 issue of Caring for the Ages. This approach includes nonpharmacological interventions which are important for older adults who often experience more severe medication side effects. 

Christine Kilgore writes that, “Chronic pain—the complex, multidimensional, highly personal experience that affects more than half of nursing home residents—demands assessment of both the physical causes and the emotional and psychosocial components.” 

As a starting point, clinicians and caregivers in nursing homes must help patients identify pain and overcome the obstacles to reporting their pain. Alzheimer’s disease and moderate to severe dementia are known risk factors for the underreporting of pain from residents, and according to Kilgore’s source, Connie S. Cole, PhD, DNP, APRN, other obstacles include: 

• Belief of some nursing home residents that pain is part of the aging process 
• Fear of pain medicine due to side effects or the possibility of addiction 
• Cultural beliefs that link pain to weakness 
• Fear of being judged if they report pain 
• Trauma history 
• Socialization 

The article suggest that pain assessments be completed at several points in a resident’s stay, not just upon admission. Attention must also focus on signals such as a grimace or withdraw from conversation when pain flares. Nursing assistants have proven to be a vital part of observing these signals and their assessments were more accurate than other clinicians. 

The bottom line, frequent communication that puts residents at ease can help them feel more empowered to report pain and receive treatment.