Assessing Pain in the SNF

Many times as consultants when we go into buildings the staff expresses to us that they are having difficulty treating the patients.  The reason being the patient is typically in too much pain.  First on the agenda should be to find records and  look at the documentation for that pain.  Therapy and Nursing can be documenting the type of pain, the location of pain, and the intensity of the pain.  A facility should glance at how they are documenting intensity of pain as there are a number of different scales.  You can use a numeric scale, verbal scale, or a pictorial scale depending on your population.  Once you have got the pain management documented, then you can start looking at the interventions you want to put in place.  Tracking that documentation is going to help you determine those interventions.

Therapy can play a significant role in the management of pain in the geriatric population.  Considering that the general aging population is likely to have degenerative conditions, bony changes, and muscle atrophy, it is expected that these individuals with experience some degree of discomfort and pain.

 Therapists have many skills and tools that may be appropriate for pain management, and may alleviate or decrease the need of pain medications.  Considering that the elderly patient is on an average of 13 medications, this can be significant.  Therapy interventions that can impact pain include the following: 

• Modalities - Moist Heat. Ultrasound. Electrical Stimulation
• ROM
• Soft tissue massage
• Joint mobilizations
• Positioning
• Therapeutic exercises – stretching