The Clinical journal of pain
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The purpose of this paper is to present salient principles of pain management in nursing homes and other long-term care settings. ⋯ Clinicians who care for patients receiving long-term care services must help establish a treatment plan that is reasonable given the limited resources and skills available in nursing homes and other long-term care facilities. Medication regimens should be simplified as much as possible. Contingency plans for pain management must be anticipated and made available so that delays do not occur during medication changes or dosage adjustments. Long-term care facilities need substantial support from physicians and other pain experts for education to continuously update their skills and knowledge. As the need for health systems for frail elderly persons continues to grow, it is important to provide comfort and effective pain control appropriate for these new settings.
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Comparative Study
Pain intensity assessment in older adults: use of experimental pain to compare psychometric properties and usability of selected pain scales with younger adults.
To determine: (1) the psychometric properties and utility of 5 types of commonly used pain rating scales when used with younger and older adults, (2) factors related to failure to successfully use a pain rating scale, (3) pain rating scale preference, and (4) factors impacting scale preference. ⋯ Although all 5 of the pain intensity rating scales were psychometrically sound when used with either age group, failures, internal consistency reliability, construct validity, scale sensitivity, and preference suggest that the VDS is the scale of choice for assessing pain intensity among older adults, including those with mild to moderate cognitive impairment.
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To better understand the nature of age differences in pain and nociception with the aging of the worlds' population. ⋯ The clinical implications are obvious; older persons are likely to be especially vulnerable to the negative impacts of pain and pain associated events.