5. MYTH
Many elders tend to not report
their pain because they think
it is a natural part of growing
older.
6. Fact or Myth
Opioids should not be
considered when treating
elders with severe pain.
7. MYTH
Opioids are the first line of
defense we have to combat
severe pain. Opioids have no
maximum daily dose.This allows
us to adjust dose to effective
level, no matter how severe.
19. • Fear of legal issues
• Fear of regulatory scrutiny
• Unfamiliarity with opioids
• Fear of patient addiction
• Concern about detrimental
side effects
• Lack of communication by
health care personnel and
the patient/family
21. • Worry about cost
• Fear of addiction
• Fear of losing independence
• Don’t want to be a bother
• Culture
• Fear of side effects
• Cognitively Impaired
• Depression
• Low expectations for pain
relief
22. True or False
A person’s pain is whatever
they say it is and exists
whenever they say
it does.
23. This is the definition advocated
by Margo McCaffery and is
subscribed to by many pain
management programs.
TRUE
24. Give three signs of pain
that might be exhibited by
cognitively impaired elders.
25. Changes in emotion (tears)
Changes in movement
(restlessness)
Verbal cues (whimpering,
screaming)
Facial cues (grimacing)
Changes in body position
(guarding)
38. How often should the nurse
complete a comprehensive
pain assessment?
39. Admission/Readmission
Change in pain status or health
status
Each Minimum Data Set/
Outcome and Assessment
Information Set (MDS/OASIS)
Assessment
40. Name three things to
educate the elder and family
about when implementing
opioids or pain
management.
41. Benefits of effective pain
management
Options available
Goal of treatment
Side Effects and their treatment
(bowels!)
Cost
Negative effects of pain
Pain symptoms – including
nonverbal
42. True or False
The elderly usually have
at least three different
sites of pain.
43. And it is important to assess
each pain site separately and
document according to
WILDA criteria.
TRUE
44. List at least three differences
between acute and chronic
pain.
45. Acute Pain
Short term
Sudden onset
Usually known
cause
Usually goes away
Typically doesn’t
cause severe
emotional stress
Chronic Pain
Often unknown
cause/onset
Causes depression,
sadness, anxiety,
anger, loss of control
May continue
throughout life and
requires
comprehensive
treatment
46. What are some non-
pharmacological
interventions that the
departments other than
nursing can do?
47. Involve in activities
1:1 room visits
Aromatherapy
Touch – massage, lotion
Take on walks
Read
Support groups
51. World Health Organization
▪ Systematic approach to treat
mild, moderate and severe pain
52. Jeopardy Game Template adapted from the work of Susan Collins and
Eleanor Savko, District Resource Teachers for Hardin County Schools:
www.hardin.k12.ky.us/res_techn/sbjarea/math/MathJeopardy.htm
This material was prepared by the New Mexico Medical Review Association
(NMMRA), the Medicare Quality Improvement Organization for New Mexico,
under contract with the Centers for Medicare & Medicaid Services (CMS), an
agency of the U.S. Department of Health and Human Services. It is based on
material produced by the Kansas Foundation for Medical Care.
The contents presented do not necessarily reflect CMS policy.
9SOW-NM-PS-08-36
