V. Special Population
         B.  Pain Management, Palliative and Long-Term Care in the Elderly

This section includes Clinical Practice Guidelines on the Management of Pain in the Elderly from the American Geriatric Society and the American Medical Directors Association. 

       City of Hope Publications

  1. Dale, W., Mohile, S., Eldatah, B., Trimble, E., Schilsky, R., Cohen, H., Muss, H., Schmader, K., Ferrell, B. R., Extermann, M., Nayfield, S., & Hurria, A. (2012). Biological, clinical, and psychosocial correlates at the Interface of Cancer and Aging Research. The Journal of the National Cancer Institute, 104(8), 581-589. DOI: 10.1093/jnci/djs145.
  2. Kelly, K., Thrane, S., Virani, R., Malloy, P., & Ferrell, B. R. (2011). Expanding palliative care nursing education inCalifornia: The ELNEC geriatric project. 
    International Journal of Palliative Nursing, 17
    (4), 188-194. 
  3. Borneman, T., Koczywas, M., Sun, V., Piper, B. F., Uman, G., Ferrell, B. R. (2010). Reducing patient barriers to pain and fatigue management. Journal of Pain and Symptom Management, 39(3), 486-501. DOI:10.1016/j.jpainsymman.2009.08.007.
  4. Kelly, K., Ersek, M., Virani, R., Malloy, P., & Ferrell, B. R. (2008). End-of-life nursing education consortium geriatric training program: Improving palliative care in community geriatric care settings. Journal of Gerontological Nursing, 34(5), 28-35.

       Recommended Publications

  1. Geriatric Palliative Care  
    Goldhirsch, S., & Chai, E., Meier, D, & Jane Morris. (2014).  NY: Oxford University Press.  ISBN:019538931X.   

  2. Jablonski, A. M., DuPen, A. R., & Ersek, M (2011). The use of algorithms in assessing and managing persistent pain in older adults, American Journal of Nursing, 111(3), 34-43. 

  3. Herr, K., Coyne, P. J., McCaffery, M., Manworren, R., & Merkel, S. (2011). Pain assessment in the patient unable to self-report: position statement with clinical practice recommendations. Pain Management Nursing, 12(4), 230-250. 
    DOI: 10.1016/j.pmn,2011.10.002.

  4. Strohbuecker, B., Eisenmann, Y., Galushko, M., Montage, T., & Voltz, R. (2011). Palliative care needs of chronically ill nursing home residents in Germany: Focusing on living, not dying. International Journal of Palliative Nursing, 17(1), 27-34. 

  5. Evidence-Based Geriatric Nursing Protocols for Best Practice, 4th Edition
      - Boltz, M., Capezuti, E., Fulmer, T., Zwicker, D., & O'Meara, A. (2011). NY: Springer Publishing Company.   ISBN: 

  6. McCleane, G. (2010). Pain management in older people. Reviews in Clinical Gerontology, 20, p. 183-192. DOI: 10.1017/S0959259810000146.

  7. Ersek, M., Herr, K., Neradilek, M. B., Buck, H. G., & Black, B. (2010). Comparing the psychometric properties of the Checklist of Nonverbal Pain Behaviors (CNPI) and the Pain Assessment of Advanced Dementia (PAIN-AD) instruments. Pain Medicine, 11(3), p. 395-404.  DOI: 10.1111/j.15264637.2009.00787.x.

  8. Herr, K., Bursch, H., Ersek, M., Miller, L. L., & Swafford, K. (2010). Use of pain-behavioral assessment tools in the nursing home: Expert consensus recommendations for practice.  Journal of Gerontological Nursing, 36(3), 18-31. 

  9. Coker, E., Papaioannou, A., Kaasalainen, S., Dolovich, L., Turpie, I., & Taniguchi, A. (2010). Nurses’ perceived barriers to optimal pain management in older adults on acute medical units. Applied Nursing Research, 23, 139-146. DOI: 10.1016/j.apnr.2008.07.003.

  10. Kaye, A. D., Baluch, A., & Scott, J. T. (2010). Pain management in the elderly population: A review. The Ochsner Journal, 10(3), 179-187.

  11. Arnstein, P. (2010). Balancing analgesic efficacy with safety concerns in the older patient. Pain Management Nursing, 11(2), Suppl 1), S11-S22. DOI: 10.1016/j.pmn.2010.03.003.

  12. Herr, K. (2010). Pain in the older adult: An imperative across all health care settings. Pain Management Nursing, 11(2), S1-S10. 

  13. Bruckenthal, P. (2010). Integrating nonpharmacologic and alternative strategies into a comprehensive management approach for older adults with pain. Pain Management Nursing, 11(2). P. S23-S31. DOI: 10.1016/j.pmn.2010.03.004.

  14. Wood, B. M., Nicholas, M. K., Blyth, F., Asghari, A., & Gibson, S. (2010). Assessing pain in older people with persistent pain: The NRS is valued but only provides part of the picture. The Journal of Pain, 11(12), p. 1259-1266.DOI:10.1016/j.jpain.2010.02.025.

  15. Takai, Y., Yamamoto-Mitani, N., Okamoto, Y., Koyama, K., & Honda, A. (2010). Literature review of pain prevalence among older residents of nursing homes. Pain Management Nursing, 11(4), p. 209-223. DOI: 10.1016/j.pmn.2010.08.006.

  16. 16.     Gianni, W., Ceci, M., Bustacchini, S., Corsonello, A., Abbatecola, A. M., Brancati, A. M., et al. (2009). Opioids for the treatment of chronic non-cancer pain in older people. Drugs & Aging, 26 (Suppl 1), 63-73. 
    DOI: 10.2165/11534670-000000000-00000.

  17. McKendrick, M. W., Ogan, P., & Care, C. C. (2009). A 9 year follow up of post herpetic neuralgia and predisposing factors in elderly patients following herpes zoster. Journal of Infection, 59(6), 416-421. 
    DOI: 10.1016/j.jinf.2009.09.008.

  18. American Geriatrics Society Panel on the Pharmacological Management of Persistent Pain in Older Persons. (2009).Pharmacological management of persistent pain in older persons. Journal of American Geriatrics Society, 57, 1331-1346. DOI: 10.1111/j.1532-5415.2009.02376.x.

  19. Pain Management for Older Adults, A Self Help Guide
     -Hadjistavropoulos, T., & Hadjistavropoulos, H. D. (2008). WA: IASP Press.  ISBN: 931092701.       

  20. D’Arcy, Y. (2008). Pain in the older adult. The Nurse Practitioner, 33(3), p. 18-24.  
    DOI:  10.1097/01.NPR.0000312997.00834.ce.

  21. Blyth, F. M., Rochat, S., Cumming, R. G., Creasey, H., Handelsman, D. J. Le Couteur, D. G., et al. (2008). Pain, frailty and comorbidity on older men: The CHAMP study. Pain, 140, 224-230. 

  22. Cann, P. (2008). Pain in older adults should not be seen as part of ageing. British Journal of Community Nursing, 13(12), 574-576.

  23. Pain in Older People
     - Crome, P., Lally, F., & Main, C. J. (2008).  Oxford University Press. ISBN: 0199212619.

  24. Pain Management for Older Adults, A Self Help Guide
      - Hadjistavropoulos, T., & Hadjistavropoulos, H. D. (2008). WA: IASP Press.  ISBN: 931092701.

        Educational Materials/Curriculum

  1. Detecting Discomfort in Dementia: Focus on Behaviors – Alliance of State Pain Initiatives (ASPI), Madison, WI
    -An educational video toolkit to help nursing assistants understand their role in providing good care for cognitively impaired residents in pain.  
    Includes a 13 minute DVD and a booklet Tools for Inservice Education   

  2. Pain Care Fast Facts: 5-Minute Clinical Inservice  UW Health, Madison, WI  
     - Assessing Pain in the Nonverbal or Cognitively Impaired, 3rd Edition            

  Guidelines/Clinical Pathways

  1. Clinical Practice Guideline: Pain Management in the Long Term Care Setting 
    Published by the American Medical Directors Association (AMDA).  The guideline is directed toward the entire interdisciplinary team - as well as patients and their families - in order to achieve effective pain management.   
  2. Management of Persistent Pain in Older Persons  
     -Clinical Practice Guidelines from the American Geriatrics Society.  
  3. State of the Art Review of Tools for Assessment of Pain in Nonverbal Older Adults   
              -      Criteria for Evaluation 
    Comparison Grid 
    Comparison of Tool Items
              -      Review References
              -      Detailed Information or Brief Summaries 

    -      Abbey Pain Scale (Abbey, J., et al.)
    -      Assessment of Discomfort in Dementia (ADD) Protocol, (Kovach, C.R., et al.)
              -      Certified Nurse Assistant Pain Assessment
                     Tool (CPAT) (Cervo, F., et al.)

          Checklist of Nonverbal Pain Indicators (CNPI),
                     (Feldt, K.)
              -      Disability Distress Assessment Tool (Dis DAT)
                      (Regnard, D., et al.)
              -      Discomfort Behavior Scale (DBS) (Stevenson,

          Discomfort Scale-Dementia of the Alzheimer’s
     (DS-DAT), (Hurley, A., et al.)

          Doloplus 2, (Wary, B.)
              -      Elderly Pain Caring Assessment 2 (EPCA-2)
                      (Morello, R., et al.)

          Face, Legs, Activity, Cry and Consolability Pain
                    Assessment Tool
     (the FLACC), (Merkel, S.I., et
              -      Mobilization-Observation-Behavior-Intensity-
                       Dementia Pain Scale (MOBID) (Husebo, B.S., et

          Nursing Assistant-Administered Instrument to
                      Assess Pain in Demented Individuals
    (NOPPAIN), (Snow, A.L., et al.)
    -      Pain Assessment in Advanced Dementia 
    (PAINAD) Scale
    , (Warden, V., et al.)
    -      Pain Assessment for the Dementing Elderly 
    (PADE), (Villaneuva, M.R., et al.)
              -      Pain Assessment in Noncommunicative Elderly
                      Persons (PAINE) (Cohen-Mansfield, J., et al.)
    -      Pain Assessment Scale for Seniors with Severe
     (PACSLAC), (Fuchs-Lacelle, S.K., et
              -      Pain Behavior for Osteoarthritis Instrument for
                     Cognitively Impaired Elders (PBOICIE) (Tsai, P.,
                      et al.)

        Other Organizational Links

          AARP (American Association of Retired Persons)

          Administration on Aging

          Advancing Excellence in America’s Nursing Homes  
          AgingCare.com: Connecting caregivers  
          Aging Parents and Elder Care

          Aging with Dignity

          Alzheimer’s Association
          Alzheimer’s Disease Education and Referral Center (ADEAR)

          American Assisted Living Nurses Association

          American Association for Long Term Care Nursing
          American Chronic Pain Association
          American Geriatrics Society    
          American Society on Aging
          Care Force: Excellence in Care Management  
          Caregiver Action Network   
          Clinical Geriatrics  
          Geriatric Pain         
          GeriPal: A Geriatrics and Palliative Care Blog
          Gerontological Advanced Practice Nurses
          Gerontological Society of America  
          In the Face of Pain  
          Long Term Care Planning Network  
          MISS Foundation: A community of compassion and
       hope for grieving families
          MySeniorCare: A community for senior housing,
        home care & health
          National Association Directors of Nursing
       Administration in Long Term Care
          National Gerontological Nursing Association  
          National Institute on Aging  
          Nurses Improving Care for Healthsystem Elders
          Organ Procurement and Transplantation Network
          Palliative Care for Seniors, Care Givers and Families
          Rheumatoid Arthritis Learning Center

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