Pain management in older adults
In the current ageing population, the number of geriatric patients seen by healthcare professionals is increasing. Older adults tend to have more co-morbidities and medication usage and (chronic) pain is highly prevalent in older adults.
There is increasing evidence that professionals tend to underestimate the pain presented in older people, because it is often assumed that it is simply a part of getting older. As a result older patients are often under-medicated and miss-managed.
A diminished functional status and physiological reserve as well as cognitive impairment can all complicate an adequate pain assessment and management. A number of scales are developed to measure behavioural responses to pain. This paper lists the following consistent observable phenomena associated with pain:
- Physiological observations;
- Facial expression;
- Body movements;
- Changes in interpersonal interactions;
- Changes in activity or routines;
- Changes in mental status.
Pain management should also include medication. The WHO 'three step analgesic ladder' is a well-accepted drug regime for use with older adults. Appropriate drug regimes along with the behavioural pain assessment are important factors for pain management in older patients. Further research is needed to improve pain management in the elderly. > From: Schofield, Medicine 41 (2013) 34–38. All rights reserved to Elsevier Ltd.