Abstract

AbstractPain management is a hallmark of quality end-of-life care. This presentation will define pain trajectories in nursing home (NH) residents’ last six months of life, and show how these trajectories are influenced by health care aides (HCAs) and their working environment.This observational study utilizes the RAI-Minimum Data Set (MDS) linked to the TREC Measurement System (TMS) survey. MDS provides resident-level longitudinal data on pain plus various clinical measures. TMS captures point-in-time metrics on HCA supply, their characteristics (e.g., time rushed, feelings of empowerment) and their working environment (e.g., team leadership, care culture). Data are available on a representative sample of NHs from Western Canada.Data were analyzed on 982 residents in their last six months of life. Pain levels were negligible for 60.6% of residents during this time, and increased substantially or remained high for 34.4%. The effect of HCAs and contextual factors on these pain trajectories is discussed.

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