This study compared
pain assessment and management in the last 48 hours of life for hospice and nonhospice
nursing home residents. Included were 209 hospice and 172 nonhospice residents in 28 nursing homes in six geographic areas. Hospice patients were considered short-stay (seven days or less) (n=51), or longer-stay (over seven days) (n=158). Of residents not in a hospital or a
coma (n=265), 33% of nonhospice residents, 6% of short-stay and 7% of longer-stay hospice residents had no documented
pain assessment (P<0.05). For those with
pain documented (n=93), longer-stay hospice residents, compared to nonhospice residents, had a significantly greater likelihood of having received an
opioid (adjusted odds ratio [AOR] 5.4; 95% CI 1.3, 21.7), and an
opioid at least twice a day (AOR 2.7; 95% CI 0.9, 7.7; P=0.07). Study results suggest that hospice enrollment improves
pain assessment and management for
nursing home residents; they also document the need for continued improvement of
pain management in nursing homes.