No abstract

These results provide preliminary support for the construct validity, strong ordinal properties, and strong test-retest reliability of the FPS with a sample of elderly individuals. The equality of intervals in the FPS has not been fully supported in the older adult, but given the complexity of the task used, the results should not be considered to be refuted. Further evaluation of the FPS with experimental and clinical pain conditions and comparison with other standard pain assessment instruments in the elderly population are warranted.

Although all 5 of the pain intensity rating scales were psychometrically sound when used with either age group, failures, internal consistency reliability, construct validity, scale sensitivity, and preference suggest that the VDS is the scale of choice for assessing pain intensity among older adults, including those with mild to moderate cognitive impairment.

Despite acknowledgment that pain is likely to be a major problem for many older adults, it is difficult to accurately estimate the frequency of pain problems for this population because of the lack of systematic epidemiological investigation. This article reports a study of the prevalence and nature of pain in a population of 3,097 rural persons 65 years and older (the Iowa 65+ Rural Health Study). Of the subjects, 86% reported pain of some type in the year prior to the interview, and 59% reported multiple pain complaints. Joint pain was the most prevalent site of pain reported, followed by night leg pain, back pain, and leg pain while walking. As reported severity of pain increased, there was a corresponding increase in impact on daily activities.

Establishing a trusting, caring relationship that acknowledges suffering and demonstrates caring is an important first step toward pain management in the elderly. The content of assessing pain in the elderly is similar to that for younger individuals. However, the source of information, manner and timing of assessment, method, and amount of data collected must be adapted to meet the special needs of the elderly individual. Strategies for assessing pain in the elderly must be adapted for those with sensory, cognitive, or psychomotor deficits. Many tools currently available for assessing pain may be effective when adapted to accommodate these changes. Interpreting reports of pain and pain-related behaviors in the elderly is complicated by myths and misunderstandings commonly held by the elderly and many health professionals. Careful consideration must be given to the meaning of pain or lack of pain report, as well as personal biases, which may influence the interpretation of pain behaviors.