Many nursing home seniors are in serious pain in their final months: study

A third of nursing home residents experience ongoing, significant pain during the last six months of life.

That’s the finding of a a new study conducted by researchers at the University of British Columbia, University of Manitoba, and University of Alberta.

Senior author Genevieve Thompson, a nursing professor at the University of Manitoba, said 60 per cent of residents reported consistent low or mild pain, whereas around 34 per cent reported moderate or severe pain across different assessment periods.

“This tells us that once the pain was present it remained constant, and few residents saw any improvement as they approached death,” explained Thompson.

Between 2007 and 2012, researchers analyzed the pain evaluations of 962 seniors in Alberta, Manitoba, and Saskatchewan nursing homes.

These assessments—no pain, mild, moderate, or excruciating pain—for the six months immediately preceding death formed the focus of the study, says the UBC article.

What will researchers take from this data?

Study co-author and UBC nursing professor Jennifer Baumbusch said, “Easing pain is such a critical part of end-of- life care, and yet we know little about how pain persists over a period of time. “This new knowledge suggests that we need a more aggressive approach to treating pain based on the information provided by the residents themselves.”

Practical Pain Management, a website that reviews various pain treatment options, has highlighted the benefits of incorporating an exercise program, albeit moderate, as a method of pain management for seniors.

The benefits of exercising range from improved physical function, balance, and mental acuity, with a reduction in isolation and depression.

Unfortunately, for many elderly people, their movement can be restricted, making exercise a difficult or impossible task.

The article also lists opioids: morphine, oxycodone, fentanyl, and methadone as a way to manage one’s pain. These common painkillers are prescribed to treat acute and chronic pain, though they do come with the risk of addiction and side effects. And the use of opioids should be handled differently with the elderly, say medical professionals Marc Ginsburg, Shawna Silver and Hershl Berman, who penned an article on the subject for the journal Geriatrics and Aging.

“The use of opioid medications and converting among them in the older adult population can often be challenging,” the trio says. “Physiological changes in older adults may affect metabolism and cognitive abilities. Due to renally cleared metabolites, some opioids, such as morphine, should be used with caution among older adults. Others, such as meperidine, should never be used at all.”

So what about non-drug options? With the growing popularity of holistic medicine, some studies are claiming things such as exercise, acupuncture or marijuana can be used to diminish pain, especially in the elderly.

Baumbusch added while previous research examined the pain of nursing home residents, this new study is the first to look at how pain levels change over time.

According to the article, future studies will focus on the effect of palliative or hospice services, nursing home size or environment, and other factors on residents’ pain levels.

The study was published in the Journal of the American Medical Directors Association.

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