Family says resident in pain when resident says no

[Donnagg123]

I know the answer but want opinions. What to do when a patient family is insistent that the person is in pain, yet the patient consistently denies pain and no symptoms of pain when family says resident is. Here is what happened. A patient who is hospice but still able to talk / make decisions etc. When one particular family member is there they are telling nursing that resident is in pain. Yet when patient is asked if in pain res denies it. Family says patient moans out, says resident tells them is hurting, hallucinates, and is awake off and on (while family sitting next to bed hovering over while patient sleeps), sits up and moans. NO ONE sees these "displays" of pain that they say they are seeing even when observing resident for long periods. When resident does actually have occasional complain of pain tylenol is effective. Yet particular family member is insistent that he needs morphine. What to do? I know there are times residents feel more comfortable telling family they are in pain versus nursing but we cannot force someone to take pain medication, right?

[loriangel14, RN]

I would ignore the family member and rely on your own nursing assessment.

[JBMmom, MSN, NP]

I explain to families that when a resident is alert and oriented I take their answers as the final say. I then explain to a family member that if I were to medicate them with a narcotic although they denied pain (unless it's scheduled) that could be considered abuse- ignoring their rights as a patient. It's a little dramatic, but it gets the family to think about what they're doing in trying to get me to medicate against a patient's wishes. In their defense, we do have a couple residents that will always deny pain to staff but complain of pain to family. Without any indicators of pain, though, I wouldn't medicate either.

[bluegeegoo2, LPN]

I have had the opposite problem as well. Family doesn't want their loved one started on morphine at end of life because they don't want them to get "addicted." ........Anyway, with those that insist we medicate their person I ask the resident in front of family if they are in pain. If they say no, then I educate the family that I can not medicate without a verbalization or s/sx of pain, but that I will keep an eye on them and I will medicate as needed. I sometimes wish I could medicate the family.

[CoffeeRTC, BSN, RN]

If the resident is A &O , how about having a private talk with him to try and find out what is really going on? If it is okay with him, then have a talk with the family member.