Pain Management in Older Adults
Pain has been established to be poorly managed in the older adults, therefore, there is need for comprehensive guidelines in order to advice as well as inform health practitioners on the methods and approaches they can use to ensure that pain among older adults is properly tailored. According to Schofield (2013), it is highly difficult to establish a definitive pervasiveness of pain in older adults because of the differences that surround the definition and methods of measuring pain. Schofield (2013) finds out that 50 percent of the older people living in the community, and 80 percent of those who live in home care suffer from chronic pain.
Moreover, according to Schofield (2013), the older adults, who form the most vulnerable as well as frail members of the community, experience more pain as compared to the general population. Pain has been found to be more common among the older women in the society. The effect of age has also been found to be inconsistent, with a number of studies pointing to an increased prevalence with age, while others reporting a decreased prevalence with age. However, the prevalence of pain among older adults differs significantly with gender as well as location of pain. Schofield (2013) argues that the knee, hip, bank, and other body joints form the most common parts of pain among the older people.
Little has been done in efforts to investigate the effects of pharmacological interventions and few studies have endeavored into this area. Majority of the studies look at the interventions among the younger population and results from these studies are used across the age ranges. However, pharmacological interventions are very helpful in addressing pain among the older adults. It is import to note that interventional therapies exist and comprise a number of neural blocks as well as minimally invasive approaches. Intra-articular injections, especially at the knees are very efficient in managing pain (Bruckenthal, Reid, and Reisner, 2009).
According to Bruckenthal, Reid, and Reisner (2009), psychological interventions are also important in managing pain among the older people. These interventions include cognitive therapy, which may be very effective in reducing chronic pain as well as improving mood among the older adults. Self-management methods as well as approaches need to be promoted for all aspects of care because such approaches are regarded to be effective in relieving and managing pain. In providing standard practice to manage pain in older adults, various evaluation strategies must be undertaken, including reviewing the medical history, assessing the cognitive and functional status of adults, reviewing medications, and assessing the non-verbal and behavioral signs of pain among this group.
In the management and treatment of pain among the older adults, a number of approaches have been espouse, which include the use of individualized approach, facilitation of appropriate treatment and education, pharmacological, and non-pharmacological treatment. Herr et al (2006) states that many of the hospitalized older people experience both acute and persistent pain; he recommends a regular, systematic, and documented pain assessment in order to properly evaluate the effectiveness of treatment. Furthermore, according to Herr et al (2006), effective management of pain among older adults requires an individualized approach.
Pasero and McCaffery (2011) argue that in pharmacological management of pain in older persons, pain drugs should be administered on a regular basis in order to maintain the therapeutically required levels. Pasero and McCaffery (2011) also agree that documenting treatment plans would be necessary in efforts to maintain consistency across the shifts and with other care providers.
Bruckenthal, P., Reid, M. C., & Reisner, L. (2009). Special Issues in the Management of Chronic Pain in Older Adults. Pain Medicine, 10.
Herr, K., Coyne, P. J., Key, T., Manworren, R., McCaffery, M., Merkel, S., Pelosi-Kelly, J. American Society for Pain Management Nursing. (2006). Pain assessment in the nonverbal patient: position statement with clinical practice recommendations. Pain Management Nursing : Official Journal of the American Society of Pain Management Nurses, 7, 2, 44-52.
Schofield, P. (2013). Managing chronic pain in older people. Nursing Times; 109: 30, 26-27.
Pasero, C., & McCaffery, M. (2011). Pain assessment and pharmacologic management. St. Louis, Mo: Elsevier/Mosby.