Geriatric pain management, pharmacological and nonpharmacological considerations.

Abstract

Persistent pain is prevalent in the elderly population, although it is not an inevitable part of aging. It is important to understand how to manage pain effectively in old age, particularly because an increasing number of individuals are becoming older, or living longer. Several problems, less common in younger adults, may complicate the treatment of pain. An accurate pain assessment is required for the most efficient strategy of pain treatment. Challenges to an effective pain assessment include: pain underreporting by patients, atypical manifestations of pain in elderly, age-associated pharmacodynamic and pharmacokinetic changes to specific drugs, other general age-related changes, and misconceptions about tolerance or addiction to opioids. However, physicians are able to provide geriatric patients with appropriate analgesia by using comprehensive assessment involving a multidisciplinary approach, and the appropriate use of various treatment modalities

Symptom burden among people with chronic disease

“…Although the location of pain was not registered in this thesis the most common sites of pain in older people are known to be located in the back, neck, leg/knee or hip and other joints (Abdulla et al 2013). Previous studies have reported that pain is often underdiagnosed and undertreated in older people with multimorbidity (Abdulla et al 2013, Kaye et al 2014, Landi et al 2001. Sometimes older people do not discuss or mention pain when consulting their health care provider, thinking that pain is a natural part of aging (Kaye et al 2014).…”

“…Previous studies have reported that pain is often underdiagnosed and undertreated in older people with multimorbidity (Abdulla et al 2013, Kaye et al 2014, Landi et al 2001. Sometimes older people do not discuss or mention pain when consulting their health care provider, thinking that pain is a natural part of aging (Kaye et al 2014). Independently of clinical diagnosis, 25% of older people do not receive analgesic treatment for pain, and people older than 85 are even less likely to receive analgesic treatment (Landi et al 2001).…”

“…Pain was a common symptom in our studies as in others almost seven out of ten participants from the AGe-FIT study and four out of ten in the group of people diagnosed with COPD had experienced pain during the preceding week. Persistent pain is highly prevalent in older people, although it is not a natural part of aging (Kaye et al 2014). Persistent pain has a high impact on psychological wellbeing, resulting in a higher anxiety level and lower quality of life (Tse et al 2013).…”

“…However, new guidance for treating pain in the elderly was published in 2013 (Abdulla et al 2013). To manage pain, a comprehensive assessment is recommended involving a multidisciplinary approach with the appropriate use of various treatment alternatives with both pharmacotherapy, and interventional procedures such as physical rehabilitation, and psychological support (Kaye et al 2014, Abdulla et al 2013). …”

Therapeutic Actions Promoted To Terminal Patient: Professional Experience At Home Care Service

“…It is a sensory and multidimensional experience, unpleasant from the physical and emotional point of view. For this reason, it is necessary to make an accurate assessment of pain, since it is the cause of suffering and undermines the quality of life of patient [16][17][18], as demonstrated in these lines:…”