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Resident personality affects success of PRN medication

January 19, 2011
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Because of their personality styles, some nursing home residents don't ask for their PRN (as needed, or "per request of the nurse") pain medication when they need it. The reasons for this vary, based on the following types of responses.

Psychologist, finding the resident in pain: “Why didn't you tell the nurse?”

Passive: “I didn't want to bother her.”

Macho: (grimacing) “I can handle pain.”

Forgetful: “I can ask for pain medication?”



· Counsel the passive or macho types about the appropriate use of their pain medication.

The forgetful person and those who don't respond to counseling would fare better with:

· a standing order (medications dispensed at a specific time)


· the nurse asking the resident if they're in pain every time they're eligible to get pain medication

Dr. Barbera is an author and a licensed psychologist consulting in long-term care facilities in the New York City area. She frequently lectures on subjects related to psychology, aging, and nursing homes. Dr. Barbera is available for private consulting with organizations, institutions, and individuals around eldercare issues. Visit her personal blog at .


Dr. Barbera is an author and a licensed...



Excellent recommendations... it goes with the philosophy of caring for the individual as we are all different. We can't group all seniors into one stereotype. We need to assess and treat seniors individually. Thank you for sharing!

I wish there was more of an initiatve to getting staff and families on the same page with pain management. While we are at it, lets get the physicians on the same page too. This day and age, there is still so many misconceptions and myths with pain management and the elderly. Some still feel like they will become addicts if they take narcotic pain meds on a regualar basis. Some MDs, undertreat pain in the elderly for the above fear and some even feel that they can't possibly feel pain?!?

Every day that I work, I am constantly assessing, evaluating and educating families, patients, staff and the MDs reguarding pain management.

Thank you for bringing this matter more attention!

Thanks for your comment, Michelle, and the work you do. Pain management in nursing homes is a perennial issue, and, I agree, it deserves far more attention than it gets.