1. MYTH of OPIOID

2. Fact or Myth
People who take pain medication
(opioids) generally become
addicted.

3. MYTH
Less then 1 percent of those
who take opioids for pain
become addicted.

4. Fact or Myth
Elders tend to report more pain
as they age.

5. MYTH
Many elders tend to not report
their pain because they think
it is a natural part of growing
older.

6. Fact or Myth
Opioids should not be
considered when treating
elders with severe pain.

7. MYTH
Opioids are the first line of
defense we have to combat
severe pain. Opioids have no
maximum daily dose.This allows
us to adjust dose to effective
level, no matter how severe.

8. Fact or Myth
Effective pain control improves the
ability to fight disease.

9. FACT
One side effect of unrelieved
pain is a compromised
immune system.

10. Fact or Myth
Constipation is a manageable
side effect of opioid use.

11. A bowel program must always
be initiated with opioid use.
FACT

12. True or False
Communication is a key
component in good pain
management.

13. Communication must occur
between all
persons/departments.
TRUE

14. Name three reasons why
families or caregivers may not
recognize or believe elders’
reports of pain.

15. • Fear of addiction
• Culture
• Fear of side effects
• Don’t want loved one to
be “targeted or labeled”
• Knowledge deficit

16. Name three barriers to
good pain management
by health care providers.

17. • Personal biases
• Inadequate pain assessment
skills
• Lack of knowledge
• Lack of time
• Fear of patient addiction

18. Name three barriers to
good pain management by
physicians.

19. • Fear of legal issues
• Fear of regulatory scrutiny
• Unfamiliarity with opioids
• Fear of patient addiction
• Concern about detrimental
side effects
• Lack of communication by
health care personnel and
the patient/family

20. Give three reasons elders
may not report pain.

21. • Worry about cost
• Fear of addiction
• Fear of losing independence
• Don’t want to be a bother
• Culture
• Fear of side effects
• Cognitively Impaired
• Depression
• Low expectations for pain
relief

22. True or False
A person’s pain is whatever
they say it is and exists
whenever they say
it does.

23. This is the definition advocated
by Margo McCaffery and is
subscribed to by many pain
management programs.
TRUE

24. Give three signs of pain
that might be exhibited by
cognitively impaired elders.

25.  Changes in emotion (tears)
 Changes in movement
(restlessness)
 Verbal cues (whimpering,
screaming)
 Facial cues (grimacing)
 Changes in body position
(guarding)

26. What doesWILDA stand for?

27. Words to describe pain
Intensity of the pain
Location of the pain
Duration of pain
Aggravating/Alleviating factors

28. What words might a person
use to describe Neuropathic
pain?

29. • Shooting
• Stabbing
• Burning
• Tingling
• Numbness
• Radiating

30. What words might a person
use to describe
Somatic and/orVisceral pain?

31. Somatic – aching, throbbing,
gnawing
Viceral – cramping, pressure,
deep aching, referred

32. True or False
Pain medication can not be
administered to a person unless
they ask for it.

33. Staff and family should recognize
signs/symptoms of pain in
individuals and speak on their
behalf.
FALSE

34. True or False
Nursing is the only discipline
that needs to be educated on
pain.

35. All health care workers are part of
the team responsible for providing
effective pain management.
FALSE

36. Name three different non-
pharmacological interventions.

37.  Massage
 Heat/Cold
 Relaxation/
Imagery
 Distraction
 Pastoral Consult
 Exercise
 Immobilization
 TENS
(transcutaneous
electrical nerve
stimulation)
 Acupuncture
 Hypnosis

38. How often should the nurse
complete a comprehensive
pain assessment?

39.  Admission/Readmission
 Change in pain status or health
status
 Each Minimum Data Set/
Outcome and Assessment
Information Set (MDS/OASIS)
Assessment

40. Name three things to
educate the elder and family
about when implementing
opioids or pain
management.

41.  Benefits of effective pain
management
 Options available
 Goal of treatment
 Side Effects and their treatment
(bowels!)
 Cost
 Negative effects of pain
 Pain symptoms – including
nonverbal

42. True or False
The elderly usually have
at least three different
sites of pain.

43. And it is important to assess
each pain site separately and
document according to
WILDA criteria.
TRUE

44. List at least three differences
between acute and chronic
pain.

45.  Acute Pain
 Short term
 Sudden onset
 Usually known
cause
 Usually goes away
 Typically doesn’t
cause severe
emotional stress
 Chronic Pain
 Often unknown
cause/onset
 Causes depression,
sadness, anxiety,
anger, loss of control
 May continue
throughout life and
requires
comprehensive
treatment

46. What are some non-
pharmacological
interventions that the
departments other than
nursing can do?

47.  Involve in activities
 1:1 room visits
 Aromatherapy
 Touch – massage, lotion
 Take on walks
 Read
 Support groups

48. What can administration do to
support effective pain management?

49.  Effective policies
 Adequate supplies
 Training/education
programs

50. What does theWHO Ladder
stand for and how is it
used?

51.  World Health Organization
▪ Systematic approach to treat
mild, moderate and severe pain

52. Jeopardy Game Template adapted from the work of Susan Collins and
Eleanor Savko, District Resource Teachers for Hardin County Schools:
www.hardin.k12.ky.us/res_techn/sbjarea/math/MathJeopardy.htm
This material was prepared by the New Mexico Medical Review Association
(NMMRA), the Medicare Quality Improvement Organization for New Mexico,
under contract with the Centers for Medicare & Medicaid Services (CMS), an
agency of the U.S. Department of Health and Human Services. It is based on
material produced by the Kansas Foundation for Medical Care.
The contents presented do not necessarily reflect CMS policy.
9SOW-NM-PS-08-36

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Fact/Myth Barriers Assessment Education Interventions