Effective pain management in the long-term care setting.

It is essential that physicians and midlevel practitioners who care for residents in long-term care facilities be proficient in the recognition, assessment, and treatment of chronic pain. A holistic approach to the physical, emotional, social, and spiritual components of a resident's total pain and distress must be integrated into the palliative aspects of long-term care medicine. Furthermore, all practitioners must recognize and effectively manage, prevent, and/or minimize the occurrence of acute pain, breakthrough pain, incidental pain, and disturbance pain that frequently are superimposed on a resident's chronic pain.