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Geriatric Pain Management & Nursing Implications

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Geriatric Pain Management & Nursing Implications
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 's 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



References: Ebersole, P., Hess, P., Touhy, T., & Jett, K. (2005). Gerontological nursing & healthy aging (2nd ed.). St. Louis, Missouri: Elsevier Mosby, Inc.. Higgins, I., Madjar, I., & Walton, J. (2004). Chronic pain in elderly nursing home residents: the need for nursing leadership. Journal of Nursing Management, 12, 167-173. Jakobsson, U. (2004, December). Pain management among older people in need of help with activities of daily living. Pain Management Nursing, 5(4), 137-143. Minner, D. M., & Marek, K. D. (2005, June). Evidenced-based assessment and treatment of persistent pain in the community-dwelling elderly receiving home health services: a pathway. Home Health Care Management & Practice, 17(4), 293-301. Monti, D. A., & Kunkel, E. J. (1998, December). Management of chronic pain among elderly patients. Psychiatric services, 49(12), 1537-1539. Ross, M. C., Bohannon, A. S., Davis, D. C., & Gurchiek, L. (1999, June). The effects of a short-term exercise program on movement, pain, and mood in the elderly. Journal of Holistic Nursing, 17(2), 139-147. Schofield, P. (2006, March). Pain management of older people in care homes: a pilot study. British Journal of Nursing, 15(9), 509-514. American Geriatrics Society Panel on Persistent Pain in Older Persons (2002, June). The management of persistent pain in older persons. Clinical Practice Guideline, 50(6), 205-224. Board of Registered Nursing (2007). Pain assessment: the fifth vital sign. Retrieved July 14, 2007, from http://www.rn.ca.gov/practice/pdf/npr-b-27.pdf Merck & Co., Inc U.S. Census Bureau (2005). American Community Survey. Retrieved July 13, 2007, from http://factfinder.census.gov/servlet/ACSSAFFFacts?_sse=on&_submenuId=factsheet_1&_ci_nbr=&qr_name=&ds_name=&reg=&_industry=

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