Few studies have addressed this matter. Family members' education, age, gender and time to travel from their home to the patients' homes were not associated with accuracy in assessing pain. Since these family members were surrogate decision-makers for the patients, we surmise that in estimating patients' pain, caring is more important than exact relationship. Patients, caregivers and family members may all have misconceptions about pain and its assessment and treatment. Every effort should be taken to include family members and caregivers in pain education sessions and to teach them to use standardized pain assessment scales.
Family members can observe nursing staff as they assess patients' pain.
In turn, nursing staff should observe family members as they measure patients' pain and record findings. Similar to hospital pain treatment protocols, family members could be instructed in analgesic use if a certain pain level is surpassed. Pain scales may still be useful in some of these patients, and institutions should have available a variety of word, numerical and faces scales to determine which are easier for patients to use. In these cases, professional staff may have to rely solely on behavioral cues. A family member who has previously correlated behaviors with standardized pain assessments or who has correlated improvement in behavior with response to analgesics may be particularly valuable.