Reducing chronic pain for residents in long term care

Over the past several years, reducing pain levels for residents has been a quality improvement initiative and main focus for all professionals working in the Aging & Veterans Care program at Sunnybrook Health Sciences Centre.

“It’s about making a marked improvement in quality of life,” says Dr. Evelyn Williams, Head, Division of Long Term Care. “Through simple interventions we have been very successful in reducing chronic pain for our residents. For seniors, a reduction in chronic pain means more time to get out and enjoy daily life and the numerous outings and activities offered to them.”

One of the most common complaints from residents of long-term care is persistent pain. Some of the sources of chronic pain include arthritis (when the joints simply wear out), pain from sitting in one spot for too long (such as in a wheelchair), and pain from an amputation.

At a recent pain campaign event in Aging & Veterans Care, professionals from eleven disciplines within the Aging & Veterans Care program came together to share pain-relieving strategies and celebrate their achievements.

“Professionals have truly embraced this project and interdisciplinary care can make a difference. It has been central to our success in improving overall pain management, reducing levels of chronic pain in the program significantly,” added Dr. Williams.

Nursing, physicians, pharmacy, physiotherapy, occupational therapy, clinical nutrition, chaplaincy, speech-language pathology and audiology, social work, recreation and creative arts therapies were all involved in the initiative. Each discipline showcased posters highlighting discipline-specific strategies to help reduce persistent pain experienced by residents.

Support materials that have been developed by the Aging & Veterans Care team participating in the hospital wide pain collaborative include: a form to facilitate pain discussions at rounds, a pain assessment questionnaire for nursing assessments and observations, a guide for nursing documentation in the chart, and a chronic pain management algorithm.

A new booklet entitled, Team Approach to Managing Chronic Pain was also created to provide information for residents and their families. This has been distributed to all residents experiencing chronic pain, and to all of the care teams.

Dr. Williams, chair of the Pain Steering Committee, was the principal author of a three-year study devoted to reducing the prevalence of pain for the 500 residents in the Aging & Veterans Care program. Her poster was selected by the Ontario Hospital Association for the best practice competition and was featured at the OHA convention in 2005.

Sunnybrook Health Sciences Centre has a distinguished history of excellence in the care of the elderly in long-term and acute care. It was originally founded in 1948 as a veterans hospital, and today more than half a century later, it is the largest veterans care facility in Canada.