Opioids, Pain Management, and Palliative Care in a Norwegian Nursing Home From 2013 to 2018.

In Norway, approximately 50% of older people die in nursing homes (NH). Holistic care and pharmacological management are key factors in quality at the end of life. The purpose of this longitudinal study was to describe the use of opioids in an NH during a 5-year period. We focused on palliative care...

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Published in:Health Services Insights Vol. 12
Main Authors: Wergeland Sørbye, Liv, Steindal, Simen A, Kalfoss, Mary H, Vibe, Olaug E
Format: case study research tables/charts Journal Article
Published: Sage Publications Inc. 2019
Online Access:View this record in EBSCOhost
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      dt: 2019
      vid: 12
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      pub: Sage Publications Inc.
      place: Thousand Oaks, California
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        10.1177/1178632919834318
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        atl: Opioids, Pain Management, and Palliative Care in a Norwegian Nursing Home From 2013 to 2018.
      aug:
        au:
          Wergeland Sørbye, Liv
          Steindal, Simen A
          Kalfoss, Mary H
          Vibe, Olaug E
        affil: Faculty of Health, VID Specialized University, Oslo, Norway
      sug:
        subj:
          Nursing Homes Norway
          Palliative Care
          Pain Management
          Narcotics Therapeutic Use
          Human
          Aged
          Aged, 80 and Over
          Male
          Female
          Norway
          Prospective Studies
          Semi-Structured Interview
          Descriptive Statistics
          Drugs, Prescription
          Length of Stay
          Injections, Subcutaneous
          Quantitative Studies
          Data Analysis Software
          Scales
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: In Norway, approximately 50% of older people die in nursing homes (NH). Holistic care and pharmacological management are key factors in quality at the end of life. The purpose of this longitudinal study was to describe the use of opioids in an NH during a 5-year period. We focused on palliative care, symptoms, and suffering during the last 3 days before death. Data were collected from spring 2013 to spring 2018. We used the interRAI assessment instrument annually and when the resident died. We conducted a semi-structured interview with nurses on duty at the deathbed. At the time of death, the residents had an average age of 88.9 years and an average stay of 2.9 years (N = 100). At the first assessment, 19% of the residents used 1 or more type of opioids. On the day of death, 55% had an active prescription for opioids, mainly as subcutaneous injections. The results illustrate the different uses of opioids, including managing pain, dyspnoea, sedation, for comfort, as a prophylaxis, or a combination of reasons. Cancer- and cardiovascular diagnoses were the strongest predictor for using morphine (P < 0.05). Identification of the residents' needs for opioids is a challenge for palliative care nurses, both ethically and legally.
      pubtype: Academic Journal
      doctype:
        case study
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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