Hospice enrollment and pain assessment and management in nursing homes

Susan C. Miller, Vincent Mor, Joan Teno

Research output: Contribution to journalArticle

131 Scopus citations

Abstract

This study compared pain assessment and management in the last 48 hours of life for hospice and nonhospice nursing home residents. Included were 209 hospice and 172 nonhospice residents in 28 nursing homes in six geographic areas. Hospice patients were considered short-stay (seven days or less) (n = 51), or longer-stay (over seven days) (n = 158). Of residents not in a hospital or a coma (n = 265), 33% of nonhospice residents, 6% of short-stay and 7% of longer-stay hospice residents had no documented pain assessment (P<0.05). For those with pain documented (n = 93), longer-stay hospice residents, compared to nonhospice residents, had a significantly greater likelihood of having received an opioid (adjusted odds ratio [AOR] 5.4; 95% CI 1.3, 21.7), and an opioid at least twice a day (AOR 2.7; 95% CI 0.9, 7.7; P = 0.07). Study results suggest that hospice enrollment improves pain assessment and management for nursing home residents; they also document the need for continued improvement of pain management in nursing homes.

Original languageEnglish (US)
Pages (from-to)791-799
Number of pages9
JournalJournal of Pain and Symptom Management
Volume26
Issue number3
DOIs
StatePublished - Sep 1 2003

Keywords

  • End-of-life
  • Hospice
  • Nursing home
  • Pain assessment
  • Pain management

ASJC Scopus subject areas

  • Nursing(all)
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

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