title: Hospice enrollment and pain assessment and management in nursing homes.
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.
authors.affiliation: Department of Community Health, Center for Gerontology and Health Care Research, Brown University School of Medicine, 23 Stimson Street, Providence, RI 02912, USA.
authors.forename: Susan C
authors.initials: SC
authors.lastname: Miller
authors.forename: Vincent
authors.initials: V
authors.lastname: Mor
authors.forename: Joan
authors.initials: J
authors.lastname: Teno
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006738:Hospices; D006801:Humans; D007902:Length of Stay; D008297:Male; D009735:Nursing Homes; D010147:Pain Measurement; D010166:Palliative Care