J0510: Pain Effect on Sleep

J0510: Pain Effect on Sleep

Steps for Assessment

1. Read the question and response choices exactly as they are written.

2. No predetermined definitions are offered to the resident. The resident’s response should be based on their interpretation of frequency response options.

3. If the resident’s response does not lead to a clear answer, repeat the resident’s response and then try to narrow the focus of the response. For example, if the resident responded to the question, “Over the past 5 days, how much of the time has pain made it hard for you to sleep at night?” by saying, “I always have trouble sleeping,” then the assessor might reply, “You always have trouble sleeping. Is it your pain that makes it hard for you to sleep?” The assessor can then narrow down responses with additional follow-up questions about the frequency.

Coding Instructions

Code for pain effect on sleep over the last 5 days.

• Code 1, Rarely or not at all: if the resident responds that pain has rarely or not at all made it hard to sleep over the past 5 days.

• Code 2, Occasionally: if the resident responds that pain has occasionally made it hard to sleep over the past 5 days.

• Code 3, Frequently: if the resident responds that pain has frequently made it hard to sleep over the past 5 days.

• Code 4, Almost constantly: if the resident responds that pain has almost constantly made it hard to sleep over the past 5 days.

• Code 8, Unable to answer: if the resident is unable to answer the question, does not respond or gives a nonsensical response.

Coding Tips

• This item should be coded based on the resident’s interpretation of the provided response options for frequency. If the resident is unable to decide between two options, then the assessor should code for the option with the higher frequency.

• If the resident reports they had pain over the past 5 days and the pain does not interfere with their sleep (e.g., because the resident is using pain management strategies successfully), code 1, Rarely or not at all.

Examples

1. When asked, “Over the past 5 days, how much of the time has pain made it hard for you to sleep at night?” the resident replied, “I’ve had a little back pain from being in the wheelchair all day, but it felt so much better when I went to bed. The pain hasn’t kept me from sleeping at all.”

Coding: J0510 would be coded 1, Rarely or not at all.

Rationale: The resident reports pain has been present over the past 5 days but that they have had no sleep problems related to pain.

2. When asked, “Over the past 5 days, how much of the time has pain made it hard for you to sleep at night?” the resident responded, “All the time. It’s been hard for me to sleep all the time. I have to ask for extra pain medicine, and I still wake up several times during the night because my back hurts so much.”

Coding: J0510 would be coded 4, Almost constantly.

Rationale: The resident reports pain-related sleep problems “all the time” over the past 5 days, so the most applicable response is “Almost constantly.”