Pain Assessment, Management, and Impact Among Older Adults in Assisted Living

Pain Manag Nurs. 2019 Jun;20(3):192-197. doi: 10.1016/j.pmn.2019.02.008. Epub 2019 May 10.


Objectives: The purpose of this study was to describe the incidence, pharmacologic management, and impact of pain on function, agitation, and resistiveness to care among assisted living residents.

Design: This was a descriptive study.

Data sources: Baseline data from 260 residents in the second cohort of the study Dissemination and Implementation of Function Focused Care for Assisted Living Using the Evidence Integration Triangle.

Review/analysis methods: Descriptive analyses for the Pain Assessment in Advanced Dementia (PAINAD), Visual Descriptor Scale (VDS), and use of medication for pain management and hypothesis testing using linear regression analyses were performed.

Results: The majority of the sample was female (71%) and white (96%) with a mean age of 87 (standard deviation = 7). Fifty-two out of the 260 residents (20%) reported pain based on either the PAINAD or the VDS. Out of the total 260 residents, 75 (29%) received pain medication. Twenty-two out of the 52 individuals (42%) reporting pain were not getting pain medication. Controlling for age, gender, and cognition, the PAINAD was significantly associated with agitation, function, and resistiveness to care and the VDS was only associated with function.

Conclusions: The incidence of pain was low among participants based on the PAINAD or the VDS. Pain measured by the PAINAD was significantly associated with function, agitation, and resistiveness to care.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Assisted Living Facilities / organization & administration
  • Assisted Living Facilities / trends
  • Dementia / etiology
  • Dementia / psychology
  • Female
  • Geriatrics / methods*
  • Geriatrics / standards
  • Geriatrics / trends
  • Humans
  • Incidence
  • Male
  • Pain / drug therapy
  • Pain Management / methods*
  • Pain Management / standards
  • Pain Management / trends
  • Pain Measurement / methods*
  • Pain Measurement / standards
  • Pain Measurement / trends
  • Psychometrics / instrumentation
  • Psychometrics / methods