MYTH of OPIOID

Fact or Myth

People who take pain medication (opioids) generally become

addicted.

MYTH

Less then 1 percent of those who take opioids for

pain become addicted.

Fact or Myth

Elders tend to report more pain

as they age.

MYTH

Many elders tend to not report their pain

because they think it is a natural part of growing

older.

Fact or Myth

Opioids should not be considered when treating elders with severe pain.

MYTHOpioids are the first line of defense we have to combat severe pain. Opioids have no maximum daily dose. This allows us to adjust

dose to effective level, no matter how severe.

Fact or Myth

Effective pain control improves the ability to fight

disease.

FACT

One side effect of unrelieved pain is a compromised

immune system.

Fact or Myth

Constipation is a manageable side effect of

opioid use.

A bowel program must always be initiated with

opioid use.

FACT

True or False

Communication is a key component in good pain

management.

Communication must occur between all

persons/departments.

TRUE

Name three reasons why families or caregivers may not recognize or believe elders’ reports of pain.

• Fear of addiction• Culture• Fear of side effects• Don’t want loved

one to be “targeted or labeled”

• Knowledge deficit

Name three barriers to good pain management by health care providers.

• Personal biases• Inadequate pain

assessment skills• Lack of knowledge• Lack of time• Fear of patient addiction

Name three barriers to good pain

management by physicians.

• Fear of legal issues• Fear of regulatory

scrutiny• Unfamiliarity with

opioids• Fear of patient

addiction• Concern about

detrimental side effects

• Lack of communication by health care personnel and the patient/family

Give three reasons elders

may not report pain.

• Worry about cost• Fear of addiction• Fear of losing

independence• Don’t want to be a

bother• Culture• Fear of side effects• Cognitively Impaired• Depression• Low expectations for

pain relief

True or False

A person’s pain is whatever they say it is and exists whenever

they sayit does.

This is the definition advocated by Margo

McCaffery and is subscribed to by many

pain management programs.

TRUE

Give three signs of painthat might be exhibited by cognitively impaired elders.

Changes in emotion (tears)

Changes in movement (restlessness)

Verbal cues (whimpering, screaming)

Facial cues (grimacing) Changes in body

position (guarding)

What does WILDA stand for?

Words to describe painIntensity of the painLocation of the painDuration of painAggravating/Alleviating factors

What words might a person

use to describe Neuropathic pain?

• Shooting• Stabbing• Burning• Tingling• Numbness• Radiating

What words might a person use to describe

Somatic and/or Visceral pain?

Somatic – aching, throbbing, gnawing

Viceral – cramping, pressure, deep aching, referred

True or False

Pain medication can not be administered to a person

unless they ask for it.

Staff and family should recognize signs/symptoms of pain in individuals and

speak on their behalf.

FALSE

True or False

Nursing is the only discipline

that needs to be educated on pain.

All health care workers are part of the team responsible for providing effective pain

management.

FALSE

Name three different non- pharmacological

interventions.

MassageHeat/ColdRelaxation/

ImageryDistractionPastoral

Consult

ExerciseImmobilizationTENS

(transcutaneous electrical nerve stimulation)

AcupunctureHypnosis

How often should the nurse complete a

comprehensive pain assessment?

Admission/Readmission Change in pain status or

health status Each Minimum Data Set/

Outcome and Assessment Information Set (MDS/OASIS) Assessment

Name three things to educate the elder and

family about when implementing opioids or pain management.

Benefits of effective pain management

Options available Goal of treatment Side Effects and their

treatment (bowels!) Cost Negative effects of pain Pain symptoms – including

nonverbal

True or False

The elderly usually have at least three

different sites of pain.

And it is important to assess each pain site

separately and document according to

WILDA criteria.

TRUE

List at least three differences between

acute and chronic pain.

Acute vs. Chronic Pain

Acute Pain Short term Sudden onset Usually known

cause Usually goes

away Typically

doesn’t cause severe emotional stress

Chronic Pain Often unknown

cause/onset Causes

depression, sadness, anxiety, anger, loss of control

May continue throughout life and requires comprehensive treatment

What are some non-pharmacological

interventions that the departments other than

nursing can do?

Involve in activities 1:1 room visits Aromatherapy Touch – massage,

lotion Take on walks Read Support groups

What can administration do to support effective pain

management?

Effective policies Adequate supplies Training/education

programs

What does the WHO Ladder stand for and

how is it used?

World Health Organization▪ Systematic approach to

treat mild, moderate and severe pain

Jeopardy Game Template adapted from the work of Susan Collins and Eleanor Savko, District Resource Teachers for Hardin County Schools:

www.hardin.k12.ky.us/res_techn/sbjarea/math/MathJeopardy.htm

This material was prepared by the New Mexico Medical Review Association (NMMRA), the Medicare Quality Improvement

Organization for New Mexico, under contract with the Centers for Medicare & Medicaid

Services (CMS), an agency of the U.S. Department of Health and Human Services. It is based on material produced by the Kansas

Foundation for Medical Care. The contents presented do not necessarily reflect CMS policy.

9SOW-NM-PS-08-36

200 pt

300 pt

400 pt

500 pt

100 pt

200 pt

300 pt

400 pt

500 pt

100 pt

200 pt

300 pt

400 pt

500 pt

100 pt

200 pt

300 pt

400 pt

500 pt

100 pt

200 pt

300 pt

400 pt

500 pt

100 pt

Fact/Myth Barriers Assessment Education Interventions