Pain assessment and management in the long-term care setting.

The assessment and management of pain is a significant public health problem in the United States. Long-term care facilities face unique barriers and challenges to pain management due to the large population of cognitively impaired residents, little physician contact and poor pain education for nurses and nurse assistants. In addition, common misconceptions about pain and pain treatment in the elderly along with health professional and resident fears of addiction and drug toxicity, add to the problem of pain management. The basic principles of pain treatment in long-term care are identical to all other health care settings--utilizing a combination of drug and non-drug treatments. Recent efforts to institutionalize improved pain management practices, through assessment procedures and defined pain management policies, standards and education programming, is a promising venue for systemically improving pain treatment in long-term care settings.