THE PROBLEMS OF PAIN AND ITS DETECTION AMONG GERIATRIC NURSING-HOME RESIDENTS

Objective: To assess physicians' detection of pain among geriatric nur sing home residents and to determine if there are factors that may int erfere with their ability to do this. Design: Chart review and patient interview. Setting: Geriatric nursing home. Participants: One hundred nursing home residents age 65 or older. Seventy-six were communicativ e. Measurements: Demographic information, diagnoses, and medication us e were compared for several groups of residents to determine their eff ects on the detection of pain. Results: Sixty-six percent of the commu nicative residents were identified as having chronic pain. Treating ph ysicians did not detect this problem in 34% of these residents. Those whose pain was not so identified were more likely to have a neurologic disorder other than dementia. When non-communicative residents were c ompared with those who were communicative, the physicians were found t o have identified pain less frequently in the former cohort. Conclusio ns: Chronic pain is a common problem among geriatric nursing home resi dents and is frequently undetected. Identification of this problem amo ng communicative residents may be markedly improved by direct question ing about this problem at frequent intervals. New methods of assessing pain need to be created to assist in its detection among the non-comm unicative population.