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Pain Management in Post-Acute and Long-Term Care: A Comprehensive Approach

Pain is a common issue among residents in the post-acute and long-term care (LTPAC) setting. It is estimated that 45 to 80 percent of residents experience pain. Factors such as age, disability and specific conditions contribute to the increased prevalence of pain. Managing pain in the post-acute and long-term care (LTPAC) setting can be challenging due to the limited ability of residents to report and describe their pain accurately. Communication with residents and families can be streamlined by educating staff about the different types of pain. This will help with enhancing each patient’s understanding of the pain process and improve pain management outcomes in residents. 

Common causes of pain include musculoskeletal issues like arthritis, as well as injuries, cancer, postoperative status, multiple sclerosis and other chronic conditions. Effective pain management is crucial to improve the function and quality of life for these individuals.

Unmanaged pain can lead to various concerns such as decreased mobility, increased risk of falls, skin breakdown and behavioral changes. Educating staff about acute and chronic pain differences is crucial to facilitate effective communication with residents and their families, enabling them to report and describe pain adequately for improved care planning and interventions. In this article, we will explore the importance of understanding acute and chronic pain, along with key resources and challenges in pain management.

Acute pain is characterized by its temporary nature, typically lasting less than three months. It is a neurophysiological response to an injury that should be resolved with normal healing. Common causes of acute pain include surgical procedures, fractures, appendicitis and soft tissue injuries. Understanding that acute pain resolves as part of the healing process can help with expectations for management. 

Chronic pain, on the other hand, persists for months or even years. It can affect any part of the body and often interferes with daily life, leading to conditions such as depression and anxiety. Diagnosing the cause of chronic pain can be challenging, and in some cases, it may not be possible. However, a combination of medications, therapies and lifestyle changes can help manage chronic pain. It is important to understand that a pain-free life is not always achievable with chronic pain. Instead the goal is to manage the pain level to improve functional abilities overall well-being and quality of life.

To further your understanding of chronic pain, we recommend exploring the following resources:

Managing pain comes with its own set of challenges which include diagnostic, variability in process/practices, undertreatment/overtreatment and treatment options. Some of these challenges may include: 

  • Identifying and diagnosing pain accurately can be challenging due to limited findings and varying responses to treatment. Determining when alternatives to traditional pain management methods are appropriate can also be difficult.
  • Opinions and definitions of pain may vary among health care providers, which can impact the consistency of pain management approaches.
  • Striking the right balance in pain management is essential. Undertreatment may lead to inadequate pain relief and reduced quality of life, while overtreatment can result in adverse effects and overuse of opioids. Regular assessment and reassessment are crucial in finding the appropriate pain management approach for each patient.
  • Availability, cost, patient acceptance and risks can limit the pharmacological options for pain management. Nonpharmacological treatments, such as acupuncture and psychotherapy, vary in their effectiveness and may be limited in long-term care settings.

Several factors influence effective pain management such as plan of care, clarifying pain management and expectation of goals:

  • Having a comprehensive pain management plan that involves care staff and medical practitioners is important. The plan should address all aspects of pain management and actively involve patients in setting realistic goals.
  • Shared decision-making with patients or their representatives is crucial in establishing pain management goals. It is important to address the physical, functional, psychological, social, emotional and spiritual aspects of pain, considering that complete pain relief may not always be achievable.

Resources for Pain Management

To further support pain management efforts, consider utilizing the following resources:

Effective pain management is crucial for residents to improve their quality of life and overall well-being. By staff understanding the differences between acute and chronic pain and implementing comprehensive pain management strategies, health care providers and staff can enhance communication, provide personalized care and optimize pain relief. Staff play a vital role in addressing the challenges and utilizing available resources that will help ensure residents receive the best possible pain management.

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