Tip of the Month - Improve pain assessment for elderly patients

When you assess pain in elderly patients, you might have to deal with multiple drug interactions, poor hearing, and confusion, says Alexis M. Newton, RN, CNS, MSN, clinical nurse specialist/educator for the ED at University of Colorado Hospital in Denver.

Here are six ways to improve pain assessment in elderly patients, recommended by Newton:

1. Ask about medications, and assess use of multiple drugs and possible drug interactions.

2. Identify any barriers to communication such as poor hearing, visual impairment, or impaired speech and thought processes.

3. Consider psychosocial barriers, such as the presence of abusive caregivers, which will impede your assessment of pain or possible injuries.

4. Communicate clearly and slowly with the use of open-ended questions to prompt responses.

5. Paraphrase to confirm that you understood the patient’s responses.

6. When using a numeric pain scale, explain what you mean by 1 vs. 10.