Pain as a Health Risk

By Rebecca Rengo, MA, MSW, LCSW, ACSW

Pain is a significant health problem that is often unrecognized or under treated with residents in long term care. Among the institutionalized elderly, up to 83% report at least one pain problem. Left untreated, pain can lead to substantial health and social problems, including: cognitive changes with impaired memory/thinking; behavioral problems; appetite changes (frequently decreased); mood disorders (depression, anxiety); disrupted sleep; increased fatigue; trouble breathing deeply and decreased walking/functioning , increasing the risk for falls. Pain can cause slower rehabilitation and it weakens the immune system, increasing risk for colds/flu. Pain can destroy relationships, creating more stress and difficulties with family and staff. Pain decreases a person’s overall quality of life.

Pain is a complex process, it’s not just the physical cause (sometimes this can’t be determined), but also the person’s prior pain history, different biological factors, psychological status and how people are interacting with them. Pain is unique to each person; you can’t judge someone’s pain.

The elderly as a group do not report pain, you have to ask. Pain is not a natural part of aging. Everyone deserves treatment, whatever age or functional status. There are many different types of pain management options. Pain responds best when treated early and promptly. Addiction is misunderstood and rarely occurs with this population. It’s important for everyone working with residents to take a close look at your own beliefs, are they correct?

Speak up and be an advocate for good pain care.

1. Share this with your nursing staff and ask how monitoring for pain is done in your facility.
2. Share this with all nursing home employees; everyone should be encouraged to report resident pain.
3. Talk directly with your CNA’s to find out if it’s easy for them to report pain.