Pain Management Pain Management Purpose This program is to describe basic pain management principles related to types of pain, how to recognize pain, and how to use pharmacological and non pharmacolog.
Pain Management Purpose: This program is to describe basic pain management principles related to types of pain, how to recognize pain, and how to use pharmacological and nonpharmacological pain treatments Brought to you by Objectives • Understand how the management of pain affects the quality of life of the LTC resident • Develop an awareness of misconceptions and consequences of untreated pain • Recognize different types of pain and identify appropriate analgesics for each type Brought to you by Objectives, cont • Utilize pain assessment tools as needed for facility residents • Understand how to determine correct doses of analgesics, as resident needs change • Understand that all team members have a role in assessment and treatment of pain Brought to you by Introduction Responsibility for Effective Pain Relief • Pain is what a patient says it is • Pain is totally subjective • In LTC, residents no always verbalize their pain but express it is other ways • LTC residents often have more than one source of pain • LTC residents are at increased risk of drug interactions Brought to you by Introduction, cont • Pain is common at end of life as a result of arthritis, circulatory disorders, immobility, neuropathy, cancer and other age-related conditions • Everyone experiences pain differently • Older patients report pain differently • Institutionalized elderly are often stoic about pain Brought to you by Introduction, cont • One person’s report of severe pain may seem like almost nothing compared to another • Caregiver’s challenge is to assess all relevant factors without imposing personal biases • Resident’s self-report of pain is the single most reliable indicator of pain Brought to you by Introduction, cont • All LTC staff and resident’s family share in the role of pain management • Residents may not have pain when not moving and caregivers report pain when he or she is moving or doing ADLs • Everyone caring for the resident must know to recognize and report pain Brought to you by “In any LTC facility, the quality of the pain control will be influenced by the availability of a pain management program and the training, expertise, and experience of its members.” Brought to you by Common Misconceptions about Pain • The caregiver is the best judge of pain • A person with pain will always have obvious signs such as moaning, abnormal vital signs, or not eating • Pain is a normal part of aging • Addiction is common when opioid medications are prescribed Brought to you by Common Misconceptions about Pain, cont • Morphine and other strong pain relievers should be reserved for the late stages of dying • Morphine and other opioids can easily cause lethal respiratory depression • Pain medication should be given only after the resident develops pain • Anxiety always makes pain worse Brought to you by Opioid Use in the Elderly, cont • Older persons may have fluctuating pain levels • • • and require rapid titration or frequent breatkthrough medication Long-acting are generally suitable once steady pain levels have been achieved Once steady pain relief levels are achieved, controlled-released formulas can be used Fentanyl patches should not be placed on areas of the body that may receive excessive heat Patches may be contraindicated with exceptionally low body fat Brought to you by Pain Management Risk for LTC Residents • Frail elderly at risk for both under and over • • • • treatment of pain NSAIDS and acetaminophen are effective and appropriate for a variety of pain complaints NSAIDS risk gastric and renal toxicity Unusual drug reactions more common in the elderly Staff must be aware of side effects and there must be an effective communication method for staff to know adverse drug reactions Brought to you by What Everyone Can to Manage Pain • Show that you care • Talk to the resident, even if he/she doesn’t • • • understand Talk to, not around, the resident Make the room pleasant Take care of the basics-glasses, hearing aides, dry clothes toileting, food, fluids Communicate with the team-let others know what works Brought to you by What Everyone Can to Manage Pain, cont • Always report pain Pain IS NOT a normal part of aging • Understand the care plan for pain-pain management is a team approach • Use relaxation methods to decrease anxiety and muscle tension • Use tactile strategies like stroking and massage • Music, art and meditation can be very helpful • Don’t forget the team Pt for mobility and safety, OT for positioning and splints Brought to you by MDS and Regulatory Requirements The following MDS items could be primary or secondary triggers for recognizing pain: • Section E.1 Mood and Behavior Patterns For example, repetitive verbalization, persistent anger, repetitive health complaints; sad, worried, facial expression, crying, tearfulness, repetitive movements, reduced social interaction Brought to you by MDS and Regulatory Requirements, cont • Section E.4 Mood and Behavior Patterns For example, wandering, verbally abusive, physically abusive, socially inappropriate, resists care • Section F.2 Psychosocial Well-being For example, covert/open conflict or repeated criticism of staff, unhappy with roommate, unhappy with other residents Brought to you by MDS and Regulatory Requirements, cont • Section I.1 Disease Diagnoses For example, deep vein thrombosis, arthritis, hip fracture, missing limb, osteoporosis, pathological bone fracture, cancer • Section I.2 Infections For example, wound infection • Section J.2 Pain Symptoms Brought to you by MDS and Regulatory Requirements, cont • Section K Oral/nutritional status • • For example, mouth pain Section L Oral/Dental Status For example, inflamed, swollen, bleeding gums, abscesses, ulcers or rashes Section M Skin conditions For example, skin ulcers, abrasions, bruises, rashes, skin tears, cuts, surgical wounds, skin treatments; foot problems Brought to you by MDS and Regulatory Requirements, cont Requires the facility to address the resident’s pain: “Each resident shall receive personal attention and nursing care in accordance with his/her condition and consistent with current acceptable nursing practice.” Brought to you by MDS and Regulatory Requirements, cont Requires facility to make a comprehensive assessment: “A facility must make a comprehensive assessment of resident’s needs, using the RAI specified by the state.” Brought to you by MDS and Regulatory Requirements, cont Requires facility staff to develop a comprehensive care plan to address pain: “The facility must develop a comprehensive care plan for each resident that includes measurable objectives and timetables to meet a resident’s medical, nursing, mental, and psychosocial needs that are identified in the comprehensive assessment.” Brought to you by MDS and Regulatory Requirements, cont Requires facility staff to meet the pain needs of the resident: “Each resident must receive and the facility must provide the necessary care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being, in accordance with the comprehensive assessment and plan of care.” Brought to you by This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause Brought to you by Our views have increased the mark of the 35,000 Thank you viewers • Looking forward for franchise, collaboration, partners Brought to you by Brought to you by Contact :-Us ,011-25464531 ,011-41425180 011-66217387 91-+,91-9818308353 + 9818569476 othermotherindia@gmai l.com www.other-mother.in Saxbee Consultants Details :-www.parveenchadha.com https://cparveen.wix.com/other-mother https://twitter.com/othermotherindi http://www.linkedin.com/profile/view?id=326103341&trk=nav_responsive_tab_profile https://www.facebook.com/pages/Other-Mother-Nursing-Crusade/224235031114989?ref=hl A WORLDWIDE MISSITION JOIN US ... Brought to you by What Everyone Can to Manage Pain, cont • Always report pain Pain IS NOT a normal part of aging • Understand the care plan for pain- pain management is a team approach • Use relaxation... of pain is the single most reliable indicator of pain Brought to you by Introduction, cont • All LTC staff and resident’s family share in the role of pain management • Residents may not have pain. .. are broken bones, strep throat, and pain after surgery or injury Brought to you by Descriptions of Pain Categories of Pain by Duration Chronic Cancer Pain Pain is expected to have an end, with