Pain and Psychological Function in Late Life

Parmelee, Patricia A.

doi:10.1007/978-1-4899-0283-2_10

Cited by 18 publications

(16 citation statements)

References 92 publications

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“…[21] [94] The association between pain and anxious mood has received far less empirical attention than the association between pain and depression. [92] Because of the close association between depression and anxiety among older adults, it is reasonable to expect that anxiety also is a strong concomitant of pain. [92] Therefore, assessment and treatment recommendations for concurrent depression and pain also apply to coexisting pain and anxious mood states.…”

Section: Psychosocial and Functional Assessmentmentioning

confidence: 99%

“…[92] Because of the close association between depression and anxiety among older adults, it is reasonable to expect that anxiety also is a strong concomitant of pain. [92] Therefore, assessment and treatment recommendations for concurrent depression and pain also apply to coexisting pain and anxious mood states. The Profile of Mood States [85] and the Pain Discomfort Scale [68] have been psychometrically tested for use among elderly patients and can be used to assess for anxiety in the older adult experiencing pain.…”

Section: Psychosocial and Functional Assessmentmentioning

confidence: 99%

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Assessment and measurement of pain in older adults

Herr

Garand

2001

Clinics in Geriatric Medicine

342

255

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Although the empirical base is still limited when providing clear directions for pain assessment and management in older adults, it is possible to identify recommendations for guiding practice based on consensus and a developing scientific base to support best practice activities. This article offers a brief overview of the epidemiology and consequences of pain, followed by a summary of issues and approaches relevant to pain assessment in older adults. Cohort specific recommendations for comprehensive pain assessment and measurement are then addressed. Prevalence and Consequences of Pain in Older AdultsOlder individuals frequently suffer from both acute and chronic painful diseases, have multiple diseases, and take numerous pain medications, [2] although relatively little investigative or clinical attention has been paid to the assessment of pain in the geriatric population, compared with the general population. This is surprising because populationbased figures indicate that the prevalence of pain is twofold higher in those over age 60 (250 per thousand), compared with those under age 60 (125 per thousand). [24] [79] [108] Further, prevalence estimates suggest that approximately 60% of community-dwelling older adults and up to 80% of elderly long-term care facility residents experience substantial pain.[24] [79] [108] Because pain is often remediable, [2] [25] it is thought that the high prevalence estimates of unrelieved pain in elderly persons may result from underrecognition, which in turn results in undertreatment. [65] [91] [120] The consequences of untreated pain can profoundly impact the older person's quality of life. In addition to physiologic risks associated with untreated pain (e.g., cough suppression with subsequent retention of pulmonary secretions), depression, [58] [39] [90] Therefore, it is imperative that health care professionals' knowledge and skills related to pain assessment in older adults be improved, and aggressive approaches to comprehensive pain assessment be adopted, to ensure and improve the quality of life of our senior citizens. Approaches to Pain Assessment with Older Adults Clinical AssessmentIn the clinical setting, accurate assessment of pain is critical for the identification of appropriate interventions and for evaluating the effectiveness of such interventions. Patients should be assessed regularly for the presence of pain and for improvement, deterioration, or complications attributable to pain treatment.[2] The frequency of the follow-up should be a function of the severity of the pain and the potential for adverse effects of treatment. Documentation of pain assessment formalizes the pain assessment process and is essential in the provision of individualized care from both a legal and professional perspective. [17] Inherent in the assessment of pain among older adults is the understanding of its potentially remediable components. For example, if a patient has acute pain, assessment should focus on the underlying pathology responsible for the pain stimulus. If th...

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Section: Psychosocial and Functional Assessmentmentioning

confidence: 99%

Section: Psychosocial and Functional Assessmentmentioning

confidence: 99%

Assessment and measurement of pain in older adults

Herr

Garand

2001

Clinics in Geriatric Medicine

342

255

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“…Many barriers exist to effective treatment of pain in nursing homes. Physicians and nurses lack knowledge about current pain practices for the elderly (Mobily & Herr 1996) and often have attitudes and beliefs against the use of strong pain medications (Strong, Ashton & Chant 1992; McCaffery & Ferrell 1997; Parmelee 1997; Brockopp et al 1998). Residents and family members often have attitudes and beliefs about pain and pain medication that prevent reporting pain or requesting pain medication (Brown & Williams 1995; Ferrell 1996; Davis, Hiemenz & White 2002).…”

Section: Background and Significancementioning

confidence: 99%

Translation Research in Long‐Term Care: Improving Pain Management in Nursing Homes

Jones¹,

Fink²,

Vojir³

et al. 2004

Worldviews Ev Based Nurs

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“…1995, Brockopp et al. 1996, Stein & Ferrell 1996, Parmelee 1997, Weissman & Matson 1999). They often fear further tests and treatments motivated by concern that their disease is worsening and a fear of increasing dependence (Hofland 1992) or death (Stein & Ferrell 1996).…”

Section: Literature Reviewmentioning

confidence: 99%

Chronic pain in elderly nursing home residents: the need for nursing leadership

Higgins

Madjar

Walton

2004

Journal of Nursing Management

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The incidence of chronic pain amongst elderly people in nursing homes is very high, making pain in this population a serious problem for aged care facilities. Research studies reveal a pattern of poor pain management in this setting despite the high incidence of pain suggesting that the management of pain in nursing homes is limited in scope and only partially effective. What is not fully appreciated by health professionals is the impact pain has on the lives of elderly people who live in nursing homes. In the study reported here a phenomenological method was used involving several in depth interviews with elderly people over a period of 9 months. Field notes of observations were also recorded as the participants went about their everyday lives in the nursing home. The discussion focuses on some of the themes drawn from the study with an emphasis on a key theme 'being constantly pained'. The findings of the study highlight what it is like to experience pain and how this impacts on everyday lives of elderly people. The paper concludes with some suggestions for health professional for improving care in this area.

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Pain and Psychological Function in Late Life

Cited by 18 publications

References 92 publications

Assessment and measurement of pain in older adults

Assessment and measurement of pain in older adults

Translation Research in Long‐Term Care: Improving Pain Management in Nursing Homes

Chronic pain in elderly nursing home residents: the need for nursing leadership

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