Aim of Investigation
The pain situation among older adults is still a major challenge in residential care homes (RCH). The increasing number of people with severe dementia and the resulting consequences for an adequate pain assessment illustrates the necessity of health care professionals' knowledge, skills, and competencies in pain management nursing.
The aim of the investigation, as part of a registered cluster-randomized controlled, was to get to know how nurse identify chronic pain and how they differentiate it from acute pain in older adults not able to self-report.

Methods
The trial was conducted from 2016 - 2018. Within the study nurses in 20 RCH were interviewed with the focus pain management for chronic pain. Beside others we added open ended questions on the differentiation between and assessment of acute and chronic pain. A qualitative content analysis according to Mayring was conducted.

Results
 In the survey 311 nurses participated. Responds showed, nurses do differentiate between acute and chronic pain.

Conclusions 
To achieve optimized outcomes for older adults in RCH nurses should have the knowledge and understand of the different pain syndromes. The results show the necessity to assess individual abilities of nurses in pain nursing and support the increase in competencies. It might bring changes and nurses can serve as advocates and negotiated the best individual care plan for the older adults who are not able to self-report or negotiate their treatment.

MAKE THE DIFFERENCE BETWEEN ACUTE OR CHRONIC PAIN IN OLDER ADULTS NOT ABLE TO SELF-REPORT