But if that first line of detection isn't there because they aren't identifying residents in pain, there is a breakdown in the system of being able to manage pain effectively. This can have serious consequences for the physical and mental health of older adults. Depression was found to be highest among nursing home residents whose pain went undetected, the study also showed. And ratings of well-being were highest among those inaccurately judged to be in pain. That may be because those residents felt they were getting more attention from the caregivers so they felt more satisfied or positive, Horgas speculated.
Pain assessment is difficult for all health professionals no matter their level of training.
It comes down to a need for education about pain detection for all staff, including nursing assistants, who are typically the least well-trained. Although the study was small and conducted in only a single nursing home, the results point to a need for better education about pain and more standardized ways of evaluating pain within nursing homes so that all health-care professionals are making assessments based on the same measurements, Horgas said. In addition, Horgas said, family members and friends of nursing home residents can help caregivers by providing information about how their loved one shows signs of pain. Horgas' research addresses a number of important issues related not only to pain in the elderly, but chronic pain in general, according to Robert Yezierski, director and founder of the Pain Program in the Miami Project at the University of Miami, who will be the director of the Center for Pain Research at UF starting late next month. Studies like the one of Dr. Horgas are important as they provide a much needed perspective on current practices and point out what we need to address in the future in order to ensure the elderly pain patient a quality of life they are entitled to.