Pain Management in the Elderly
Pain is a complex, subjective, and unpleasant sensation derived from sensory stimuli and
modified by memory, expectations and emotions (Merck & Co., Inc., 1995). It is a
multidimensional and universally experienced phenomenon, however, the reactions and
sensitivity to pain varies widely among individuals, especially for the geriatric population
(65 years and older). Pain is a common experience for many elderly individuals that has
negative consequences on their health, functioning and quality of life (Monti & Kunkel,
1998). This is of particular concern because the geriatric population is the fastest growing
segment in the United States, and is projected to double to 72 million by the year 2030
(U.S. Census Bureau, 2005). It is estimated that individuals over the age of 65 suffer from
pain twice as much as young adults, and the percentage of adults living in long term care
that experience chronic pain is 70-80% (U.S. Census Bureau, 2005).
In terms of pain management, the elderly are the most undertreated and ineffectively
controlled segment of the population. Due to the prevalence of pain among the elderly,
managing it requires special attention to possible cognitive impairment, physiological
changes, disease comorbidity and cultural beliefs about pain. This paper examines
considerations and effective methods for managing pain among the elderly in a range of
health care settings, substantiated by several research studies that provide evidence-based
data. Specifically, the research considered looked at the incidence and types of pain
experienced among the elderly, barriers to ineffective pain management, assessment of
pain in the elderly, pharmacological and non-pharmacological approaches to treatment,
and the affect of unrelieved pain on an elder activities of daily living and overall
functioning.
Pain that results from injury, surgery or any break in skin tissue that stimulates peripheral
sensory receptors is called nociceptive pain. It can cause acute pain which typically lasts
anywhere from a few days up to several weeks, and subsides with healing. Pain that lasts
longer than six months is called persistent or chronic pain (Merck & Co., Inc., 1995). This
is the type of pain that most geriatric patients experience because they often have more
than one disease process present. According to Schofield, it is suggested that 80% of those
over the age of 65 suffer from at least one chronic illness (2006). Chronic pain is common
in the elderly, and can be exacerbated by, those who have degenerative joint diseases,
osteoarthritis, diabetes mellitus, vascular diseases, cancer, infection, ulcers, dementia,
