A high percentage of older Americans experience ongoing or intense pain, but few are receiving adequate pain medication. Unmanaged pain causes increased misery, can lead to anxiety and depression, and often causes an elderly person to withdraw from social contact.
In addition to psychological trauma, unmanaged pain can eventually cause an increase in falls, immobility, sleep loss, and decreased appetite (which can lead to malnutrition).
Twice as many older adults report feeling pain as do younger adults. Yet, statistics show that as many as 85 percent of the elderly do not receive adequate treatment for their pain.
What Contributes to Under-Managed Pain?
- Age – The older you are, the less likely you are to receive pain medicine.
- Ethnicity – Minorities are more likely to be under-treated.
- Ability to communicate – Healthcare providers find it more difficult to detect pain in nonverbal or otherwise cognitively compromised people, which includes those with memory loss.
- Lack of reporting – Some elderly people believe that pain is part of aging, or they try to ignore it for fear it signals the progression of their disease. Others keep silent about their pain rather than “bother” their nurse.
- Lack of access – Some patients can’t get to the pharmacy for their prescriptions or cannot afford them. Others encounter managed care obstacles.
- Misunderstanding – One study found that healthcare providers who had experienced major pain were more likely to adequately medicate.
- Interactive complications – Multiple medical problems, drug interactions, or medication side affects can mask pain symptoms.
Some Solutions
While pain is common among the elderly, it is not “normal.” Here are some suggestions to help lessen your loved one’s pain.
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Remind your loved ones to tell someone when they’re in pain.
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- Reassure them it won’t affect the care provider’s – or anyone else’s – opinion of them.
- Identify any causes for pain denial (religious or cultural beliefs, fear, personal beliefs).
- Develop a “pain scale” to help them determine the intensity of the pain (a scale of one to five; with one being the most unbearable pain).
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Learn to recognize behavioral clues of pain.
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- Facial expression
- Body movements
- Aggressive behavior
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- Irritability
- Change in daily activities
- Physiological clues (pulse, temperature, respiration rate)
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Familiarize yourself with alternative pain treatments.
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- Physical exercise
- Hot and cold treatments
- Relaxation techniques
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- Distraction and imagery
- Treatment for depression
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Learn about various pain medications.
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- Weaker painkillers like codeine
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- Stronger painkillers like morphine
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Get to know the pain management team.
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- Your loved one
- Family members
- Physician
- Pharmacy
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- Care provider or primary care nurse
- Nursing supervisor, if in a care facility
- Administrator
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Develop a pain-management plan.
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- If your loved one is in a care facility, ask about its policy on pain management.
- Help draw up a pain management plan acceptable to you and your loved one.
- Insist that steps to relieve pain be taken within 15 minutes of each new report of pain.
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There is no scientific test to determine whether your loved one is in pain. If they tell you they are in pain, believe them – then work to eliminate or minimize their pain. |
Sources:
- 1. Gaston-Johansson F, et al. Undertreatment of pain in the elderly: Causes and prevention. The Annals of Long-Term Care; 7(5).
- 2. Teno J, et al. Persistent pain in nursing home residents. The Journal of the American Medical Association; 285(16).
- 3. Pain management in the elderly population. The American Geriatrics Society.
- 4. Bernabei R, et al. Management of pain in elderly patients with cancer. The Journal of the American Medical Association; 279(23).
- 5. Warren B. Ineffective treatment of pain for the elderly. University of Kansas.
- 6. Pain management: Medical, legal, ethical issues – Part II. Kansas Elder Law Network.
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