Barbara Resnick, PhD, RN, CRNP, FAAN, FAANP, is working to implement guidelines that promote better pain recognition and practical, low-risk interventions that can make a meaningful difference.
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A new approach is helping nursing home staff recognize pain and avoid the risks of unnecessary medication.
For Barbara Resnick, PhD, RN, CRNP, FAAN, FAANP, this approach starts by helping others rethink what pain looks like. In residents with dementia, it’s rarely as simple as someone saying, “I hurt.”
“If you’re in pain but can’t tell me you’re in pain, how are you going to express it?” said Resnick, a professor at the University of Maryland School of Nursing. “Well, it might be through just being kind of cranky — you get a little cranky when you’re hurting. You might hit me because I’m trying to move something that hurts. But that’s not perceived as pain, it’s perceived as bad behavior, and so we miss a lot of pain in this population.”
That misinterpretation can trigger a cascade of harm: resistance to care, skipped meals or hygiene, infections, and hospitalizations. To change that, Resnick is helping nursing home staff implement updated national guidelines from PALTmed — the Post-Acute and Long-Term Care Medical Association. These guidelines support better pain recognition, emphasize identifying the root cause, and encourage non-drug strategies as a first line of care.
Resnick’s approach promotes practical, low-risk interventions that can make a meaningful difference. Sometimes, it’s as simple as trimming long nails or talking with a resident about a happy memory. She also points out that non-pharmacological approaches are safer for people with dementia, noting, “If you start using opioids, they’re going to have an increase in confusion. There’s also a big risk for an increase in falls.”
In a new video Q&A, Resnick explains how rethinking pain in dementia care could dramatically improve quality of life for millions without added risk.
Read more about how UMB researchers are tackling real-world challenges and making a lasting impact on lives everywhere.