The Role of Nursing Assistants in Managing Nursing Home Residents’ Pain: A Scoping Review

Under-recognized and under-treated pain is common in nursing home (NH) residents, especially those with cognitive impairments (CI). Resident pain is associated with poorer resident health and quality of life and more staff stress. Nursing assistants (NAs) spend more time with residents than other care providers but their role in pain management is not well defined. This scoping review examined the literature on the NA’s role in managing NH residents’ pain. The literature search resulted in 60 references which were organized into the following themes: workforce issues, perceptions related to resident pain, recognition and assessment, and interventions. The research is still relatively new in this field. It appears that NA workforce issues (e.g., absenteeism, turnover, staffing levels, education) are important to pain management, but the relationship between these variables is not well understood. Because pain experiences are individual and more common during movement, the NAs’ knowledge of the resident and assistance with activities of daily living (ADLs) put them in an ideal position to recognize pain, especially in residents with CI. While NAs are motivated to help residents, factors (e.g., misconceptions of pain, a lack of formal pain education, and tension with nurses) sometimes impede NA recognition and communication of resident pain. Most of the research to date focused on the NA’s role in the recognition and assessment of pain, but additional testing is needed before distributing clear guidelines for NA pain assessment. Preliminary research indicates that NAs may also have an important role to play in both preventing pain during ADLs (e.g., bathing and oral care) and administering nonpharmacological treatments (e.g., massage and hot packs).Bachelor of Scienc