Monthly Archives for December 2001

The Best of…Research Confronts Nursing Homes’ Pain-Management Problems

Published December 10, 2001, Pawtucket Times

         Nobody says that old age is easy, especially for those who ultimately end up being admitted into a nursing  facility.  And for those residing in facilities, there is a very high probability of being in pain, Brown University researchers say.  One of the first nationwide research studies reported in the Journal of the American Medical Association last April that pain is “prevalent, persistent and poorly treated in nursing facilities.”    

         According to the JAMA study, nursing facilities across the country provided “woe-fully inadequate pain management” with a large majority of the residents ultimately experiencing excruciating severe pain just months after admission.  Furthermore, the researchers acknowledged that the study results may even “underestimate the actual pain burden.

        The study noted that for those able to report on their pain, the rate of persistent pain in Rhode Island facilities was 46.4 percent. Nationally, the rate is 46.7 percent.  For those in pain, persistent pain left untreated experience impaired mobility, depression, and a reduced quality of life, the researchers say.
 
        The Rhode Island Quality Partners, Inc., Brown University Researchers and 18 Rhode  Island nursing facilities came together last year to confront this issue by improving  how nursing facility residents are assessed for pain and how pain is managed.   At a press conference held last month, it was reported that all facilities participating had put into place pain policies and procedures, which included both the use of medication management and non-drug interventions like massage, music and aroma therapies and heating packs.

        During the 15 month study, the participating nursing facilities attended two-hour educational seminars each month.   The seminars were conducted by the project partners and, with the assistance of nurse facilitators, each facility began to develop pain policies and procedures, and worked with the project partners to implement the treatment protocols.

       Preliminary findings show a nearly 10-fold increase in the rate of comprehensive assessment of pain among the 18 nursing facilities, as well as a five-fold increase in the use of pain intensity scales to monitor the resident’s pain.  Translation.  Nursing facility residents benefited from the facility’s efforts to confront this care issue.

       “Some Rhode Island facilities watch previously inactive residents begin to participate in a variety of activities.  Others found that residents could cut back on some of their medications once their pain was well controlled,” stated Dr. David R. Gifford, principal clinical coordinator with Rhode Island Quality Partners.

       “Nursing facilities were able to get together, share and work closely with each other to try to improve pain management, despite the staffing shortages, inadequate Medicaid reimbursement despite all the other regulations they are trying to comply,” Gifford told All About Seniors.  “The participating facilities deserve credit for putting the time and resources into the project to improve an area of care that every one is concerned about, that is inadequate pain management.”

       “Both scientific and professional literature clearly tell us that pain management has been an area that can be controlled but it has not been,” states Wayne Farrington, Chief, Facilities Regulation, at the State’s Health Department.  “Sadly nursing facility residents have been living with unnecessary pain and implementing the best practices that were determined by this research project will greatly enhance the quality of life in 103 Rhode Island facilities.” 

        Hopefully, the states nursing home industry will disseminate the methods and practices identified as being successful by this research project to every facility in the state.  At least in Rhode Island, nursing facility residents should not be suffering from unnecessary pain.

        Herb Weiss is a Pawtucket, Rhode Island-based writer covering aging, health care and medical issues.  This article appeared in December 10, 2001 in the Pawtucket Times. He can be reached at hweissri@aol.com.

Holiday event brings volunteer opportunities, cheer to seniors

Published in The Pawtucket Times on December 3, 2001

Jane Edwards plays the lead role of the set designer and seamstress.  Pawtucket residents Velma Jacks, Rita Kenney Anne Curry and Loraine Farley work as painters.  Bill Curry cuts out wooden signs and figures of Santa Claus, elves and reindeer.  Over the last couple of months, these six retirees have worked vey closely with 14 members of Winter Wonderland committee and others to gear up for the upcoming weekend’s kick-off of Pawtucket’s third annual Winter Wonderland Festival.

The holiday festival runs for three consecutive December weekends, on Saturdays and Sundays from 4 to 8 p.m., at Slater Memorial Park in Pawtucket.  The wildly successful Pawtucket festival that has attracted thousands to the Pawtucket’s largest park was first held in December 1999.  The year before, a visit in December 1998 to a California’s city’s annual holiday display was all it took to lifelong Pawtucket resident Janice McHale thinking about creating a similar event in Pawtucket.

The 61 year old, who had worked the past 38 years at Blackstone Valley Electric, then the past five years at its parent EUA Service Corp in West Bridgewater, remembered holiday displays at Slater Park in the early 1960s.  After a while, these displays just disappeared, she said.

Coming back to Pawtucket, McHale had made up her mind to bring back holiday displays to Slater Park.  “It could easily be done here in Pawtucket, and it would look good, too.” she quipped.

In spring 1999, a quick visit where she pitched her idea to Pawtucket Mayor James E. Doyle and Jack Carney, the city’s Public Works Director, resulted in the approval of her pet project.  City Council President John Barry III, along with City Councilors Don Grebien and Raymond “Chip” Hoyas, jumped on board too, strongly supporting McHale’s vision, a Winter Wonderland festival in Pawtucket.

While not committing coty funds, Doyle pledged in-kind support.  This assistance would come in the form of providing manpower and technical expertise.  The city’s project engineer, the late Frank Rendine, was sought out to design 18 two-story Victorian houses.  Staff in the Mayor’s Office and Department of Planning and Redevelopment would be charged with publicity, bookkeeping and raising funds.  Finally, Public Works and Parks and Recreation would set up the small Victorian Village and 100 Christmas trees and bring electricitiy to the site.

Scores of volunteer carpenters and painters from the community would ultimately build the huge three-dimensional plywood structures.  Most importantly, local businesses brought funding to the project, providing the seed money to begin the new endeavor.

Now in its third year, the Winter Wonderland Committee has evolved into a nonprofit corporation, headed by McHale, who is now retired.  The City of Pawtucket continues to be a major supporter of the holiday festival .  And Winter Wonderland continues to get bigger and better, McHale tell All About Seniors.

“This year you can see 200 brightly lighted Christmas trees, and enjoy more performers and vendors too”, said the festival organizer.

Like previous years, McHale notes that those coming to Winter Wonderland can still leisurely stroll through the Victorian Village, surrounded by hundreds of Christmas trees, and be entertained by carolers, bell ringers, clowns, puppeteers and musicians.  A large heated tend will again be the site for the festival’s entertainment.  Youngers can visit Santa Claus, and even take a ride on a large hay wagon, the popular R&D express train, or the carousel.  Of course, hot chocolate, hot cider and delicious food will be available in a food court.

Pawtucket resident Rita Kenney, who is in her 70s, has toiled tirelessly for months to prepare for the upcoming holiday festival’s opening.  The retired teacher and school administrator believes that the City’s Winter Wonderland festival has brought back some of the Christmas spirit to Slater Park.

Being a senior volunteer has its perks, Kenney says.  “You get to work with all ages and the experiences really reconnect you back to the community.”

To  become a volunteer or sponsor of the Winter Wonderland or to obtain a schedule of events call 726-3185.