Gerontological Nursing Chapter 16: Pain and Comfort

Ebersole and Hess' Gerontological Nursing & Healthy Aging in Canada - 3rd Edition

• This is a textbook about gerontological nursing and healthy aging in Canada, specifically focusing on pain and comfort.

Chapter 16 - Pain and Comfort

• Learning Objectives (Part 1):

  • Define pain, recognizing how older adults experience it.
  • Distinguish between acute and persistent pain.
  • Identify assessment data for pain.
  • Describe pharmacological and non-pharmacological pain relief methods.

• Learning Objectives (Part 2):

  • Discuss pain management goals for older adults.
  • Develop a nursing care plan for older adults experiencing acute or persistent pain.

Pain and Comfort

• Comfort: A balanced fulfillment of physiological, emotional, social, and spiritual needs essential for wellness.
• Pain: A distressing sensation that impacts physical, psychological, and spiritual well-being, potentially leading to reduced socialization, mobility impairments, and altered perception of life.

Communication of Pain & Discomfort

• Pain expression is shaped by individual history and perceived meaning.
• Spiritual and psychological pain may be expressed as feeling unwell.
• Pain responses reflect cultural expectations of behavior.
• Effective communication skills are crucial for understanding how older adults with or without communication challenges communicate pain.
• Factors like hearing loss, depression, medications, personality, and acceptable pain expression can impact pain communication.

Implications for Gerontological Nursing and Healthy Aging

• Pain is now recognized as the fifth vital sign.
• Older adults from minority groups and/or those in long-term care facilities are at higher risk for inadequate pain assessment and treatment.
• Nurses have a role in addressing patients' pain needs, regardless of cause or expression.
• Explore Box 16-1 (Facts and Myths about Pain in the Older Adult).

Acute and Persistent Pain

• Acute Pain: Temporary pain (from injury or procedures). Easily addressed with analgesics. Can have physical, psychological, or spiritual components.
• Persistent Pain (Chronic Pain): Not time-limited, with varying intensity. Estimated to affect 33-83% of long-term care residents. Often due to degenerative or pathological conditions.

Osteoarthritis

• The most common joint disease, affecting many adults over 50.
• Characterized by initial intermittent joint pain and stiffness, eventually becoming persistent aching in inactive joints and acute pain with activity.

Varicella Zoster

• Also called shingles.
• A viral nerve infection causing itching, stinging, and burning pain along the dermatome.
• Can evolve from acute (days to weeks) to chronic.
• Vaccination is available for older adults (50+) to reduce shingles risk.

Implications for Gerontological Nursing and Healthy Aging (Part 1)

• Nurses are often best able to recognize and address older adults' needs, and pain management is an important part of their role.
• A comprehensive nursing record is important as a tool to manage pain in this population.
• Pain assessment should include self-reported pain (e.g., verbal or written questionnaires), visual/verbal analog scales, and detailed descriptions of pain intensity, frequency, quality, and location.
• Addressing this population requires best practice and evidenced or informed resources, such as RNAO or "Try This"

Implications for Gerontological Nursing and Healthy Aging (Part 2)

• Refer to Figures 16.1, 16.2, 16.3 for further content.
• Interventions:
  • Nonpharmacological pain relief (e.g., touch, nerve stimulation, biofeedback, distraction). Relaxation and imagery methods are also useful.
  • Pharmacological pain control, including nonnarcotic and narcotic analgesics, to treat varying pain degrees.
• Evaluation:
  • Assessing frequency and intensity of pain.
  • Identifying behavioral correlates of pain.
  • Evaluating response to interventions, also noting impact on mood, ADLs, sleep and other quality-of-life factors.

This quiz delves into Chapter 16 of Ebersole and Hess' Gerontological Nursing & Healthy Aging in Canada, focusing on pain and comfort for older adults. It covers definitions, assessment, and methodologies for managing pain effectively within this demographic. Ideal for nursing students and professionals working in gerontology.