Pain Management in Skilled Nursing Facilities: What Residents Can Expect

Leaving the hospital does not necessarily mean the end of pain. Residents may need post-acute care services after surgery, injury, serious illness, or a flare of a chronic condition, and continue to experience pain that impacts their sleep, mobility, and mood and interferes with participation in the therapy they need.

This is not just about decreasing the pain score. The purpose is to manage symptoms safely to allow residents to move, participate in rehabilitation and achieve function.

What Happens When a Resident Arrives With Ongoing Pain?

The first step of pain management in skilled nursing facilities is to understand the patient’s condition. A clinician may look at the hospital discharge summary, what the resident was diagnosed with, what medications they are taking, what procedures have been performed recently and the resident’s description of pain.

The evaluation also considers more than just a numeric pain score. Is the resident able to stand, transfer, walk, sleep, and do therapy? Is the pain new, chronic, post-surgical or nerve-related? These details are important to the treatment plan.

Pain Control Has to Work With Rehabilitation

Pain can create a practical barrier to recovery. A person may be medically stable but still avoid walking, transfers, or participating in therapy because it increases discomfort. This may make rehabilitation more challenging and also lead to weakness and loss of independence.

This is where pain care and post-acute rehabilitation can support recovery. The objective is not necessarily the complete elimination of pain. Rather, clinicians can strive to manage pain to a level that enables safe engagement in therapy and daily activities for the resident.

When Pain Treatment Becomes More Complex

A more individualized approach is needed for some residents. Sometimes treatment decisions are more complicated due to chronic pain, long-term use of opioids, multiple medical conditions, or opioid use disorder.

In such cases, merely adding more pain medication to manage the pain may not solve the issue. The treatment team should reconsider the origin of the pain, discuss pain medications, include non-opioid or interventional medications, and review whether addiction treatment is necessary.

This is where addiction medicine in skilled nursing facilities can become relevant. Addiction specialists can assist with opioid use disorder management, provide support for medication-assisted treatment as needed, help prevent relapse, and connect residents to care as they move through settings.

What Residents Should Ask About Their Pain Care

Care recipients and families don’t need to know every clinical detail to be involved in care. Specific questions can help clarify treatment plans:

• What is believed to be causing the pain?
• What does each type of pain medication help with?
• How long could the medications be required?
• Does it impact alertness, balance, or therapy participation?
• How will the team be able to see the efficacy of the treatment?
• What if this strategy isn’t sufficient?

How Paragon Post Acute Care Supports Integrated Resident Care

Paragon Post Acute Care focuses on pain management, physiatry, and addiction medicine in the skilled nursing and long-term care environments. Its model integrates these services into the facility and highlights the need for coordination with other care teams, such as nursing, therapy, and the clinical support team. Post-acute care services by Paragon Post Acute Care involve drug regimens, non-drug therapies and injections like joint and trigger point injections; and its addiction medicine program provides addiction medicine management and medications for opioid use disorder. This holistic approach addresses pain, function and substance use within the broader post-acute recovery plan.

FAQs–

1. How is pain managed in skilled nursing facilities?

Pain management in skilled nursing facilities typically begins with an assessment of the pain’s cause, severity, effect on function, and current medications. Non-drug interventions or procedures may be used as needed, depending on the treatment. The plan is then reviewed based on symptom relief, mobility, therapy participation, and safety.

2. How does pain management support Post-acute rehabilitation?

Post-acute rehabilitation may involve residents moving around and performing therapy regularly. Poorly managed pain can make those activities challenging, and medication effects can equally make participation difficult. The objective of coordinated pain management is to ensure a high level of comfort while preserving the focus on mobility, safety and functional recovery.

3. When is addiction medicine needed in skilled nursing facilities?

Addiction medicine in skilled nursing facilities may be appropriate when residents have opioid use disorder, substance-use concerns, withdrawal risks, or complex medication needs. Addiction specialists can assist in medication-assisted treatment, relapse prevention, education, and ongoing treatment, as well as with coordinating addiction treatment with pain management and rehabilitation.

4. What do post-acute care services include for residents with complex needs?

Medical management, rehabilitation assistance, pain management, nursing care and specialist services are examples of post-acute care services that may be provided based on the resident’s needs. Coordinated services may connect symptom control, functional recovery, medication safety, and discharge planning for complex pain and/or substance-use issues.

Conclusion

Pain rarely exists in isolation; a resident can require nursing and physical or occupational therapy, medication management, physiatry and specialist input simultaneously. Therefore, communication among those who are a part of the resident’s rehabilitation is essential for effective post-acute care services.

Therapy participation may impact the level of pain, and the progress of rehabilitation may impact functional needs. The care plan can be reviewed regularly so that it can evolve rather than continuing to follow the original treatment plan indefinitely.

Need rehabilitation and addiction medicine support? Contact Paragon Post Acute Care to discuss integrated care services for skilled nursing and long-term care facilities.