Treating Pain: Seniors and the Opioid Crisis

About Kim Elliott

Chief Nursing Officer

When it comes to leading clinical programs, Kim is our go-to authority on resident care, while maintaining the highest standards for quality and compliance. As Chief Nursing Officer, her care philosophy is based on the importance of individualized care, personal choice and resident independence. Kim is dedicated to finding more options to help our residents live and age well. That’s why she has taken a population health approach to surrounding our residents with the healthcare services they need to help manage their chronic conditions. Kim’s passion for senior healthcare developed in nursing school during a routine rotation. When she saw a shortage of quality nurses working in senior living, Kim knew she had found her calling and a place where she could make a difference. Kim joined Brookdale in 2014. She serves on the Argentum Clinical Quality Executive Roundtable, is on the Dean’s Advisory Board for the Central Florida University School of Nursing and is a member of the Nightingale Society. She was recently inducted into McKnight’s Women of Distinction Hall of Fame. Kim has a master’s degree in Nursing, with a specialty of executive leadership from Chamberlain College of Nursing.

The opioid epidemic’s grip on America is well documented. Conversations about pharmaceutical companies, over-prescribing doctors, and addiction are news-cycle staples. These stories are punctuated with alarming statistics, like an average of 130 Americans dies a day from an opioid overdose. But the impact of pain on quality of life and the effects of the addiction epidemic on seniors are stories that aren’t often told.

According to the Agency for Healthcare Research and Quality, in 2015 and 2016 nearly 4 million older adults filled multiple opioid prescriptions at the same time and nearly 10 million filled at least one opioid prescription. In addition, there was a 34 percent jump in opioid-related inpatient hospitalizations of seniors between 2010 and 2015, despite the fact that non-opioid-related hospitalizations dropped by 17 percent.

These worrying statistics shed light on a complicated, underlying issue: pain management. Chronic pain is common among seniors, but it’s important to remember that it is not a natural symptom of aging. Underlying health conditions such as arthritis, diabetes, or heart disease can attribute to pain. Chronic pain often has a debilitating effect on the quality of life and can lead to an opioid prescription. Even with medication, 59 percent of people living with chronic pain report a decreased overall enjoyment of life, 77 percent feel depressed, and 86 percent have trouble sleeping, according to a Voices of Chronic Pain survey.

At Brookdale, we strive to improve the quality of life for our residents and patients and are sensitive to their pain management needs. I believe there are three key steps to improving pain management in seniors.

The first step is education. Train nurses, caregivers, or anyone else charged with caring for another individual on recognizing, reporting and documenting signs of pain. It’s also important to be aware of and understand that there may be non-pharmacological interventions as alternatives to prescribing medication. Physical therapy, acupuncture, massage, counseling and alternative medicine are just a few examples.

The second step is using good judgment when monitoring pharmacological interventions. Medication is prescribed when non-pharmacological approaches aren’t successfully treating pain. Take note if your resident or patient is frequently using multiple types of pain medication, or if there are orders for several types of pain medication.

The third step is anticipating, monitoring, and treating side effects. Some of the common opioid side effects are constipation, drowsiness, mood changes, allergic reaction, increased tolerance, and dependence. There should be a proactive plan to prevent constipation, since the senior population is prone to complications, such as bowel obstruction.

While there is no quick fix for pain or opioid addiction, these three steps help evaluate the impact of pain on quality of life and the effectiveness of a pain management plan.

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