Background & Aims
Pain is a common care problem among nursing homes residents 1-4. It is also well known that nursing home residents’ pain is associated with increased care dependency 5 and a decreasing quality of life 6. Even though pharmacological interventions often have limited therapeutic effect and compromises activities of daily living, and may even cause adverse, potentially fatal, side effects for residents 7-8, non-pharmacological interventions for pain management in nursing homes are seldom used. One explanation might be, that the non-pharmacological interventions may not be developed with the target groups and therefore not practical, feasible, or e.g. even not accepted by the residents. Therefore, the aim of this study was to collaboratively develop a practical and feasible toolkit for implementing non-pharmacological pain management interventions in nursing homes.
Methods
In a first step we created a list of nonpharmacological interventions based on (1) the international literature; (2) already used interventions in a nursing home and from the residents as well as (3) (inter-) national expert’s suggestions. Second, nursing home staff ranked the interventions focusing on the importance for nursing home residents. We identified the evidence for each intervention, by using eleven evidence-based websites. For each intervention we extracted data on instructions for use, indication, strength of evidence, side effects, disadvantages, contraindications, tips and tricks as well information on the publisher and date of publication. After that, workshops were held in which residents as well as nursing home staff with different qualification take part. In this workshop each intervention was discussed regarding acceptance, feasibility, which resources are needed and who is conducting the intervention or delegates the intervention, based on GRADE criteria.
Results
The first research step resulted in a list that comprised in total 50 interventions. They were ranked by the nursing home staff starting with empathic communication including listening, touching, or being positive, things followed by allowing rest including but is not limited to, resting or bed rest. The workshop will take place in April 2024. After that, the research team will include the information’s from the workshop and create the lay-friendly toolkit. One more meeting will be held at the beginning of June, on which final feedback will be given by nursing home staff, managers as well as residents.
Conclusions
In this study we collaboratively develop a practical and feasible toolkit for implementing non-pharmacological pain management interventions in nursing homes. This toolkit will be freely available for German speaking nursing homes. Due to the fact, that staff as well as residents were involved in the development of the toolkit, the reality of nursing home practice could be incorporated. Furthermore, the perspective from the residents, gave highly valuable insights into their perspectives. In a next step we will implement and evaluate this toolkit in a nursing home.
References
1.GIBSON, S. J. & LUSSIER, D. 2012. Prevalence and Relevance of Pain in Older Persons. Pain Medicine, 13, S23-S26.
2.SJÖLUND, B. M., MAMHIDIR, A. G. & ENGSTRÖM, M. 2021. Pain prevalence among residents living in nursing homes and its association with quality of life and well-being. Scand J Caring Sci, 35, 1332-1341.
3.STOMPÓR, M., GRODZICKI, T., STOMPÓR, T. P., WORDLICZEK, J., DUBIEL, M. & KUROWSKA, I. 2019. Prevalence of chronic pain, particularly with neuropathic component, and its effect on overall functioning of elderly patients. Medical Science Monitor, 25.
4.TARAKCI, E., ZENGINLER, Y. & KAYA MUTLU, E. 2015. Chronic pain, depression symptoms and daily living independency level among geriatrics in nursing home. AGRI-The Journal of the Turkish Society of Algology, 27.
5.STEENBEEK, E. D., RAMSPEK, C. L., VAN DIEPEN, M., DEKKER, F. W. & ACHTERBERG, W. P. 2021. The Association Between Pain Perception and Care Dependency in Older Nursing Home Residents: A Prospective Cohort Study. J Am Med Dir Assoc, 22, 676-681.
6.HELVIK, A.-S., BERGH, S., ŠALTYT? BENTH, J., SELBAEK, G., HUSEBO, B. S. & TEVIK, K. 2022. Pain in nursing home residents with dementia and its association to quality of life. Aging & mental health, 26, 1787-1797.
7.BESSEY, LJ, WALASZEK, A Management of behavioral and psychological symptoms of dementia Curr Psychiatry Rep, 21 (2019), p. 66
8.VIK-MO, AO, GIIL, LM, BORDA, MG et al. The individual course of neuropsychiatric symptoms in people with Alzheimer’s and Lewy body dementia: 12-year longitudinal cohort study. Br J Psychiatry, 216 (2020), pp. 43-48
Presenting Author
Manuela Hoedl
Poster Authors
Topics
- Pain in Special Populations: Elderly