Collegian
Volume 18, Issue 1 , Pages 11-18 , March 2011

The fragmented story of pain: A saga of economic discourse, confusion and lack of holistic assessment in the residential care of older people

  • Kim Wylie, RN, PhD, MN, BHSc, RN, RPN, DipCommunity Health (AssocDipClinNurs (Gerontology), Churchill Fellow, MRCN(Ret))

      Affiliations

    • University of Newcastle, School of Nursing, 14 Delaney Road, Dayboro, Queensland 4521, NSW, Australia
    • Corresponding Author InformationCorresponding author. Tel.: +61 07 3425 2760.
  • ,
  • Monica Nebauer, RN, PhD, MPhil, BAppSc(Nsg), DipAppSc(NsgEd), FRCNA

      Affiliations

    • Faculty of Health Science, Australian Catholic University, Australia

Received 9 December 2009 ,Revised 9 April 2010 ,Accepted 12 May 2010.

References 

  1. American Pain Society . In: Principles of analgesic use in the treatment of acute pain and cancer pain. 5th ed.. Glenview, IL: American Pain Society; 2003;
  2. Anderson KA, Hosier AF. Know thy residents: An exploration of long-term care nursing staff's knowledge. Research in Gerontological Nursing. 2009;2(1):69–76
  3. Angus J, Nay R. The paradox of the Aged Care Act 1997: The marginalisation of nursing discourse. Nursing Inquiry. 2003;10(2):130–138
  4. Barnett E. Including the person with dementia. Designing and delivering care. ‘I need to be me’. London: Jessica Kingsley Publishers Ltd.; 2000;
  5. Barton S, Findlay D, Blake RA. The management of inappropriate vocalisation in dementia: A hierarchical approach. International Journal of Geriatric Psychiatry. 2005;20(12):1180–1186
  6. Batavia M. Contraindications for therapeutic massage: Do sources agree?. Journal of Bodywork and Movement Therapies. 2004;8(1):48–57
  7. Bjoro K, Herr K. Assessment of pain in the nonverbal or cognitively impaired older adult. Clinics in Geriatric Medicine. 2008;24:237–262
  8. Bourbonnais A, Ducharme F. The meanings of screams in older people living with dementia in a nursing home. International Psychogeriatrics. 2010;Published online by Cambridge University Press
  9. Bruckenthal P. Assessment of pain in the elderly adult. Clinics in Geriatric Medicine. 2008;24:213–236
  10. Cairncross, L., Magee, H., & Askham, J. (2007). A hidden problem: Pain in older people. A qualitative study. Europe: Picker Institute. http://www.pickereurope.org/Filestore/PIE_reports/project_reports/paincarehomes_final.pdf Retrieved 23.10.2009.
  11. Callin S, Bennett MI. Assessment of neuropathic pain. Continuing Education in Anaesthesia, Critical Care & Pain. 2008;8(6):210–213
  12. Cartwright T. ‘Getting on with life’: The experience of older people using complementary health care. Social Sciences & Medicine. 2007;64(8):1692–1703
  13. Cohen-Mansfield J, Creedon M. Nursing staff members’ perceptions of pain indicators in persons with severe dementia. The Clinical Journal of Pain. 2002;18:64–73
  14. Cowan DT, Fitzpatrick JM, Roberts JD, While AE, Baldwin J. The assessment and management of pain among older people in care homes: Current status and future directions. International Journal of Nursing Studies. 2003;40(3):291–298
  15. Department of Health and Ageing (DoHA). (2008a). A literature review and description of the regulatory framework. 5. Clinical measures of quality of care and quality of life in residential aged care homes. http://www.health.gov.au/internet/main/publishing.nsf/Content/ageing-iar-review-framework.htm∼ageing-iar-review-framework-5.htm Retrieved 23.10.2009.
  16. Department of Health and Ageing (DoHA). (2008b). Aged care funding instrument. http://www.health.gov.au/ACFI Retrieved 23.10.2009
  17. Department of Health and Aging (DoHA). (2008c). NATFRAME – A national framework for documenting care in residential aged care services (p. 167). http://www.health.gov.au/internet/main/publishing.nsf/Content/ageing-rescare-natframe.htm∼ageing-rescare-natframe09.htm Retrieved 2.04.2008.
  18. Edvardsson D, Winblad B, Sandman PO. Person-centred care of people with severe Alzheimer's disease: Current status and ways forward. The Lancet Neurology. 2008;7:362–367
  19. Feldt K. Pain measurement: Present concerns and future directions. Pain Medicine. 2007;8(7):541–542
  20. Ferrell B. Ethical perspectives on pain and suffering. Pain Management Nursing. 2005;6(3):83–90
  21. Gagliese L. Pain and aging: The emergence of a new subfield of pain research. The Journal of Pain. 2009;10(4):343–353
  22. In:  Gibson SJ,  Weiner DK editor. Pain in older persons: Progress in pain research and management. Seattle, WA: IASP Press; 2005;p. 35
  23. Hadjistavropoulos T, Herr K, Turk DC, Fine PG, Dworkin RH, Helme R, et al. An interdisciplinary expert consensus statement on assessment of pain in older persons. Clinical Journal on Pain. 2007;23:S1–S43
  24. Heggen K, Wellard S. Increased unintended patient harm in nursing practise as a consequence of the dominance of economic discourses. International Journal of Nursing Studies. 2004;41(3):293–298
  25. Herr K. Pain assessment in cognitively impaired older adults. American Journal of Nursing. 2002;102(12):65–67
  26. Herr K, Bjoro K, Decker S. Tools for assessment of pain in nonverbal older adults with dementia: A state-of-the-science review. Journal of Pain and Symptom Management. 2006;31(2):170–172
  27. Herr K, Coyne PJ, Key T, Manworren R, McCaffery M, Merkel S, et al. Pain assessment in the nonverbal patient: Position statement with clinical practice recommendations. Pain Management Nursing. 2006;7(2):44–52
  28. Herr K, Spratt KF, Garand L, Li L. Evaluation of the Iowa Pain Thermometer and other selected pain intensity scales in younger and older adult cohorts using controlled clinical pain: A preliminary study. Pain Medicine. 2007;8(7):585–600
  29. Hicks TJ. Ethical implications of pain management in a nursing home: A discussion. Nursing Ethics. 2000;7(5):308–392
  30. Holloway K, McConigley R. Descriptive, exploratory study of the role of nursing assistants in Australian residential aged care facilities: The example of pain management. Australasian Journal on Ageing. 2009;28(2):70–74
  31. Horgas AL. Pain management in elderly adults. Journal of Infusion Nursing. 2003;26(3):161–165
  32. Horgas AL, Nichols AL, Schapson CA, Vietes K. Assessing pain in persons with dementia: Relationships among the non-communicative patient's pain assessment instrument, self-report, and behavioral observations. Pain Management Nursing. 2007;8(2):77–85
  33. Joint Commission Resources . In: Issues in provision of care, treatment and services for hospitals. 2nd ed.. Oakbrook Terrace: Joint Commission on Accreditation of Healthcare Organizations; 2008;
  34. Karp JF, Shega JW, Morone NE, Weiner DK. Advances in understanding the mechanisms and management of persistent pain in older adults. British Journal of Anaesthesia. 2008;101(1):111–120
  35. Kitwood T. Dementia reconsidered. The person comes first. Buckingham: Open University Press; 1997;
  36. Kumar, A., & Allcock, N. (2008). Pain in older people: Reflections and experiences from an older person's perspective. Help the Aged (pp. 1–41). The University of Nottingham and the British Pain Society. http://policy.helptheaged.org.uk/NR/rdonlyres/D97BB4C1-8A95-4940-91DC-BC8AFD921BFA/0/pain_in_older_people_181108.pdf Retrieved 19.11.2009.
  37. Lawson P, Richmond C. Emergency problems in older people. Emergency Medicine Journal. 2005;22:370–374
  38. McAuliffe L, Nay R, O’Donnell M, Fetherstonhaugh D. Pain assessment in older people with dementia: Literature review. Journal of Advanced Nursing. 2009;65(1):2–10
  39. McCaffery M, Pasero C. Assessment. Underlying complexities, misconceptions, and practical tools. In:  McCaffery M,  Pasero C editor. Pain: Clinical manual. 2nd ed.. St. Louis: Mosby; 1999;p. 35–102
  40. McClean WJ. A practice guide for pain management for people with dementia in institutional care. Stirling, Scotland: Dementia Services Development Centre, University of Stirling; 2000;
  41. Melding PS. Can we improve pain management in nursing homes?. The Medical Journal of Australia. 2002;177(1):5–6
  42. Miller LL, Talerico KA, Rader R, Swafford S, Hiatt SO, Millar SB, et al. Development of an intervention to reduce pain in older adults with dementia: Challenges and lessons learned. Alzheimer's Care Quarterly. 2005;6(2):154–167
  43. Morley S. Psychology of pain. British Journal of Anaesthesia. 2008;101(1):25–31
  44. Nay, R. (2008). ACFI – Tragic or terrific? In 2008 aged care quality improvement seminar (Slides 1–43). Perth: Aged Care Branch Department of Human Services. http://www.health.vic.gov.au/agedcare/downloads/pres1.pdf Retrieved 30.11.2009.
  45. Nygaard HA, Jarland M. Are nursing home patients with dementia diagnosis at increased risk for inadequate pain treatment?. International Journal of Geriatric Psychiatry. 2005;20:730–737
  46. Öhman M, Söderberg S, Lundman B. Hovering between suffering and enduring: The meaning of living with serious chronic illness. Qualitative Health Research. 2003;13:528
  47. Papaioannou A, Watts NB, Kendler DL, Yuen CK, Adachi JD, Ferko N. Diagnosis and management of vertebral fractures in elderly adults. American Journal of Medicine. 2002;113(3):220–228
  48. Parke B. Pain in cognitively impaired elderly. The Canadian Nurse. 1992;88:17–20
  49. Parke B. Gerontological nurses’ ways of knowing: Realizing the presence of pain in cognitively impaired older adults. Journal of Gerontological Nursing. 1998;24(6):21–28
  50. Pasero C. Challenges in pain assessment. Journal of PeriAnesthesia Nursing. 2009;24(1):50–54
  51. Pasero C, McCaffery M. No self-report means no pain-intensity rating: Assessing pain in patients who cannot provide a report. American Journal of Nursing. 2005;105(10):50–53
  52. Pautex S, Michon A, Guedira M, Emond H, Le Lous P, Samaras D, et al. Pain in severe dementia: Self-assessment or observational scales?. Journal of the American Geriatrics Society. 2006;54:1040–1045
  53. Pitorak E, Montana B. Pain assessment and management. In:  Matzo ML,  Sherman DW editor. Gerontologic palliative care nursing. St. Louis: Mosby; 2004;(Chapter 21)
  54. Polomano RC, Dunwoody CJ, Krenzischek DA, Rathmell JP. Perspective on pain management in the 21st century. Pain Management Nursing. 2008;9(1):S3–S10
  55. Radin, D. (2007). Experiments on intuitive knowing. In Proceedings of the ways of knowing symposium. University of Minnesota's Center for Spirituality and Healing and Life Science Foundation. http://www.lifesciencefoundation.org/07Ways03.html Abstract Retrieved 8.08.2008.
  56. Scherder E, Herr K, Pickering G, Gibson S, Benedetti F, Lautenbacher S. Pain in dementia. Pain. 2009;145:276–278
  57. Shega J, Emanuel L, Vargish L, Levine SK, Bursch H, Herr K, et al. Pain in persons with dementia: Complex, common, and challenging. The Journal of Pain. 2007;8(5):373
  58. Smith M, Buckwalter K. Behaviors associated with dementia. American Journal of Nursing. 2005;105(7):40–52
  59. Stolee P, Hillier LM, Esbaugh J, Bol N, McKellar L, Gauthier N. Instruments for the assessment of pain in older persons with cognitive impairment. Journal of the American Geriatrics Society. 2005;53(2):319–326
  60. van Herk R, Boerlage AA, van Dijk M, Baar FPM, Tibboel D, de Wit R. Pain management in Dutch nursing homes leaves much to be desired. Pain Management Nursing. 2009;10(1):32–39
  61. Vargish L, Levine SK. Case reviews in pain. Manifestations of pain in cognitively impaired older adults. The Journal of Pain. 2007;8(5):373–374
  62. Venturato L, Kellett U, Windsor C. Nurses’ experiences of practice and political reform in long-term aged care in Australia: Implications for the retention of nursing personnel. Journal of Nursing Management. 2007;15:4–11

PII: S1322-7696(10)00036-3

doi: 10.1016/j.colegn.2010.05.005

Collegian
Volume 18, Issue 1 , Pages 11-18 , March 2011