scholarly journals Pain Management in Older Persons

2021 ◽  
Author(s):  
Dabota Yvonne Buowari
Keyword(s):  
Pain Management ◽  
Pain Assessment ◽  
Older Persons ◽  
Rating Scales ◽  
The Elderly ◽  
Common Symptom ◽  
Older Person ◽  
Barriers And Challenges ◽  
Geriatric Pain ◽  
Pain In The Elderly

Pain is a common symptom in the elderly and it is problematic and distressful especially if the polder person is dependent on a caregiver. Pain keeps the sufferer uncomfortable and can affect the person from carrying out daily activities and tasks especially activities of daily living. Pain in the older person may be acute or chronic. Some of the causes of pain in the elderly are neuralgia, musculoskeletal dysfunction especially osteoarthritis, emotional and mental problems, cancer and several other causes. The assessment of pain in the elderly is done using validated pain assessment tools such as the visual analogue scale, verbal rating scales, numeric rating scales, McGill pain assessment questionnaire, pain attitudes, brief pain inventory, and geriatric pain measure. Management of pain in older persons involves non-pharmacological and pharmacological methods. There are some barriers and challenges of pain management in the elderly and also consequences when pain is not properly managed or not managed at all in an older person.

scholarly journals Pre-Hospital Pain Management in Children with Injuries: A Retrospective Cohort Study

2021 ◽  
Vol 10 (14) ◽  
pp. 3056
Author(s):  
Ada Holak ◽  
Michał Czapla ◽  
Marzena Zielińska
Keyword(s):  
Pain Management ◽  
Pain Intensity ◽  
Pain Assessment ◽  
Rating Scales ◽  
Rating Scale ◽  
Low Frequency ◽  
Numeric Rating Scale ◽  
Health Concern ◽  
School Age Children ◽  
Medical Teams

Background: The all-too-frequent failure to rate pain intensity, resulting in the lack of or inadequacy of pain management, has long ceased to be an exclusive problem of the young patient, becoming a major public health concern. This study aimed to evaluate the methods used for reducing post-traumatic pain in children and the frequency of use of such methods. Additionally, the methods of pain assessment and the frequency of their application in this age group were analysed. Methods: A retrospective analysis of 2452 medical records of emergency medical teams dispatched to injured children aged 0–18 years in the area around Warsaw (Poland). Results: Of all injured children, 1% (20 out of 2432) had their pain intensity rated, and the only tool used for this assessment was the numeric rating scale (NRS). Children with burns most frequently received a single analgesic drug or cooling (56.2%), whereas the least frequently used method was multimodal treatment combining pharmacotherapy and cooling (13.5%). Toddlers constituted the largest percentage of patients who were provided with cooling (12%). Immobilisation was most commonly used in adolescents (29%) and school-age children (n = 186; 24%). Conclusions: Low frequency of pain assessment emphasises the need to provide better training in the use of various pain rating scales and protocols. What is more, non-pharmacological methods (cooling and immobilisation) used for reducing pain in injured children still remain underutilized.

Acute pain in the elderly

2011 ◽  
Author(s):  
Adrian Wagg ◽  
Shashi Gadgil
Keyword(s):  
Pain Management ◽  
Side Effects ◽  
Acute Pain ◽  
Health Care Professionals ◽  
The Elderly ◽  
World Health ◽  
Close Monitoring ◽  
Who Analgesic Ladder ◽  
Co Morbidity ◽  
Pain In The Elderly

Physiological changes that occur with age affect the pharmacokinetics and pharmacodynamics of drugs used in acute pain management. Elderly patients are often reluctant to complain of pain and seek treatment and may sometimes be unable to express pain due to impaired cognition or language. Evidence suggests the elderly as a group that receive inadequate analgesia and are often in pain. Health care professionals are often reluctant to administer sufficient analgesia due to fear of encouraging addiction or inducing side effects. The approach to pain management in this group should follow the World Health Organization (WHO) analgesic ladder with close monitoring for potential side effects and with escalation of treatment till sufficient analgesia is achieved. Choice of drugs and the route of administration should be tailored to the individual patient and should consider the nature of their pain and any disability or co-morbidity that will affect their response to the chosen agent. Non-steroidal anti-inflammatory drugs (NSAIDs) should be used with extreme caution, monitoring for potential gastrointestinal (GI) and renal side effects and long-term use should be avoided if possible. Opioids are effective analgesics and should not be denied to the elderly but their use should be monitored carefully and side effects such as nausea and constipation anticipated and treated.

The rehabilitation of spinal pain in the elderly patient

2001 ◽  
Vol 11 (3) ◽  
pp. 277-283
Author(s):  
R Haigh
Keyword(s):  
Elderly Patient ◽  
Back Pain ◽  
The Elderly ◽  
Spinal Pain ◽  
Common Symptom ◽  
Working Population ◽  
The Third ◽  
Lower Back ◽  
Pain In The Elderly ◽  
Care Costs

Rehabilitation aims to reduce symptoms, restore function and minimize disability through an interventionist approach that is not always concerned with pathology, disease processes and cure. This approach will be described in the context of spinal pain in the elderly. The syndrome of lower back pain (LBP) is such a common symptom that it is an almost universal human experience. It is the third most commonly reported bodily symptom after headache and fatigue. In 1998, 40% adults were affected by an episode of LBP lasting more than a day, and 40% of those in pain sought medical help. The resources provided for research and clinical management of LBP are concentrated mainly on the working population. This is because of the profound biopsychosocial consequences and huge cost to society of the ‘back pain epidemic’. The direct health care costs of back pain have been estimated as £1632 million in 1998.

Pain management

2019 ◽  
pp. 549-568
Author(s):  
John Curtin
Keyword(s):  
Pain Management ◽  
Pain Assessment ◽  
Rating Scales ◽  
Interdisciplinary Approach ◽  
Opioid Analgesics ◽  
Brief Pain Inventory ◽  
Assessment Tools ◽  
World Health ◽  
Numerical Rating ◽  
Strong Opioids

Pain is described as being whatever the experiencing person says it is, and their perception of pain is determined by their mood and morale and the meaning of the pain for them. Cancer pain is common, and prevalence is related to the stage of the illness: 59% in patients undergoing treatment, and 64% in those with advanced disease. Pain is multi-causal and multidimensional, and a holistic, interdisciplinary approach to assessment is necessary, encompassing physical, psychological, social, and spiritual aspects of pain (together are ‘total pain’). A narrative approach to pain assessment is helpful, keeping the focus on the patient and their experience. Pain assessment tools can also be used to identify where pain is and how much it hurts. These include: pain body map, visual analogue scales (VAS), verbal rating scales (VRS), numerical rating scales (NRS), and Brief Pain Inventory (BPI). Classifications of pain include acute and chronic pain, nociceptive pain caused by the stimulation of nerve endings, and neuropathic pain caused by nerve dysfunction or compression. Analgesic drugs may be given according to the World Health Organization's pain relief ladder: step 1, non-opioid analgesics such as paracetamol and non-steroidal anti-inflammatory drugs; step 2, mild opioids like codeine with or without non-opioid analgesics; and step 3, strong opioids like morphine with or without non-opioid analgesics. Non-pharmacological interventions for pain management include transcutaneous electrical nerve stimulation (TENS), massage, distraction, relaxation, breathing exercises, comfort measures, and presence of the nurse. Effective communication at all stages of management is essential.

REPRINTED WITH PERMISSION OF IASP – Pain assessment in advanced dementia. Validity of the German PAINAD – a prospective double-blind randomised placebo-controlled trial

Ból ◽  
2019 ◽  
Vol 19 (4) ◽  
pp. 34-49
Author(s):  
Albert Lukas ◽  
Ulrich Hagg-Grün ◽  
Benjamin Mayer ◽  
Thomas Flscher ◽  
Matthias Schuler
Keyword(s):  
Pain Assessment ◽  
Controlled Trial ◽  
The Elderly ◽  
Study Groups ◽  
Advanced Dementia ◽  
Double Blind ◽  
Observation Instrument ◽  
Significant Difference ◽  
Pain Recognition ◽  
Pain In The Elderly

Pain in combination with dementia is a common condition that makes pain recognition significantly more difficult. This results in undertreatment of pain in those suffering from dementia. The Pain Assessment in Advanced Dementia (PAINAD) scale currently represents one of the best approaches to pain detection in dementia. In a pilot study, strong inter-rater and retest reliability of the German version (PAINAD-G) was proven. However, the available data concerning the validity of this instrument were insufficient. The aim of the study was to validate the PAINAD-G scale by a double-blind randomised placebo-controlled trial in people with advanced dementia expected to be in pain. A second aim was to examine whether other observational tools (BISAD5 Observation Instrument for Assessing Pain in the Elderly with Dementia) (German: Beobachtungsintrument fur das Schmerzassessment bei alten Menschen mit Demenz, Checklist of Nonverbal Pain Indicators, Algoplus) were also able to demonstrate a significant difference between the study groups. Surprisingly, the study revealed no difference in „pain reduction” between those treated by oxycodone compared with those treated by placebo. Equally, none of the other 3 observational tools were able to demonstrate a significant difference between the study groups. However, correlations among the 4 observational tools were mostly moderate to high. A number of possible reasons for this observation, such as difficulties regarding sensitivity to change/responsiveness, consistence of the fundamental construct, influence of the early onset study, and efficacy of the analgesic in advanced dementia are discussed.

Demographics, Pharmacoeconomics, Assessment, and Treatment of Pain in the Elderly

2004 ◽  
Vol 17 (2) ◽  
pp. 115-128 ◽  
Author(s):  
Hildegarde J. Berdine ◽  
Mary Grace Mihalyo
Keyword(s):  
Pain Management ◽  
Functional Impairment ◽  
Elderly Population ◽  
Treatment Strategies ◽  
The Elderly ◽  
Assessment Tools ◽  
Nonpharmacologic Treatment ◽  
Assessment And Treatment ◽  
Pain In The Elderly ◽  
The Impact

The burden of pain in the elderly population of our society is observed by the greater numbers of the aged who suffer from pain as compared to their younger counterparts. The elderly present difficult challenges for pain clinicians in terms of the ability to assess for pain, amid other medical and pain problems, due to cognitive, sensory, and functional impairment. Treatment with pharmaceuticals may be altered by the impact of aging. Finally, the elderly suffer financial restraints that often prevent optimal treatment of pain even if pain is identified. Principles of pain management in the elderly are reviewed in the context of special attention to assessment tools for the elderly, the evaluation of comorbid factors in the presentation of pain, and pharmacokinetic/pharmacodynamic concerns in the aging. Pharmacologic and nonpharmacologic treatment strategies are described relative to the elder.

scholarly journals Deskripsi Pengetahuan Tentang Manajemen Nyeri Pada Lansia

2019 ◽  
Vol 2 (3) ◽  
pp. 137
Author(s):  
Imelda Rahmayunia Kartika
Keyword(s):  
Pain Management ◽  
Elderly People ◽  
Quantitative Research ◽  
Descriptive Analysis ◽  
Analytical Description ◽  
The Elderly ◽  
General Picture ◽  
Keywords Pain ◽  
Pain In The Elderly ◽  
Substantial Morbidity

<p><em>The percentage of elderly people in Indonesia increases every year to reach 9.27 percent or around 24.49 million people in 2018. The health problem that often occurs in the elderly is chronic pain due to several diseases. Pain is a general picture that persists and is closely related to substantial morbidity in the elderly. This study aims to get an overview of elderly knowledge regarding pain management. Using a quantitative research design and analytical description approach, this study was conducted on 46 elderly people in the working area of the Guguak Panjang Health Center, Bukittinggi City. The elderly were given a questionnaire based on the Nursing Outcome Classification regarding Knowledge: Pain management. Data analysis used descriptive analysis to see the description of each statement point in the questionnaire. The results of this study indicate that there are still 43.5% of the elderly lacking in poor knowledge in pain management. Less knowledge influences how to deal with pain in the elderly. It is expected that the elderly will be given education about pain management so that they can improve their health status.</em></p><p><em>Keywords         : Pain, Elderly, Knowledge</em></p>

scholarly journals Evaluation of Chronic Pain and Affecting Factors in the Elderly

2021 ◽  
Author(s):  
Önder Sezer ◽  
Duygu Devran ◽  
Hamdi Nezih Dağdeviren
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Drug Users ◽  
The Elderly ◽  
Pain Scale ◽  
Affecting Factors ◽  
Drug Treatments ◽  
Geriatric Pain ◽  
Pain In The Elderly

Objective: Diseases are more seen in the elderly population, therefore pain also gains a severe probleme in this situation. It is well known that pain impairs significantly the quality of life and gives raise to an increase use of drugs. The aim of our study is to determine the severity of chronic pain in the eldely and to evaluate the conditions affecting chronic pain. Methods: We included 456 elderly patients in our study. The mean age was 71.19±6.27 (min: 65; max: 93). Patient’s sociodemografic information, diseases, use of medications, presence of chronic pain, affecting conditions and treatment applied for chronic pain, and Geriatric Pain Scale were evaluated. Results: The females integrated in tis study were 272 with a rate of 59.6 %. Regarding the geiatric pain scale 61.2 % (n: 279) had a mild pain while the other 18.6% (n: 85) had severe pain. The 87.7% were in medication of analgesics for their chronic pain. The patient’s knowledge of the used of medications was with a rate of 43.9% (n: 200). We founded a statistically significant relationship between the chronic pain and femele gender (p<0.001), older age (p=0.012), smoking users (p=0.01), nonsteroidal antiinflamatory drug users (p=0.003) and inidviduals with higher mass body index (p=0.016). Conclusion: Chronic pain in the elderly is a common complaint. The presence of pain disrupts the quality of life and puts additional burdens on the healthcare system. Detecting preventable situations that cause pain and increases severity, giving importance to non-drug treatments, increasing health literacy about the drugs used, implementing effective policies against diseases will reduce the severity of chronic pain, increasing the quality of life and significantly reducing health costs.

scholarly journals Chronic Pain Management in Older Adults

2019 ◽  
Vol 42 (2) ◽  
pp. 63-78
Author(s):  
Sirasa Ruangritchankul ◽  
Orapitchaya Krairit
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Pharmacological Treatment ◽  
Behavioral Therapy ◽  
Opioid Analgesics ◽  
The Elderly ◽  
Psychological Status ◽  
Chronic Pain Management ◽  
Pharmacological Management ◽  
Pain In The Elderly

Chronic pain in the elderly usually has negative impacts on physical and psychological status, therefore, early diagnosis and treatment should be performed. The principle of chronic pain management is assessment of pathophysiology which leads to different choices of treatment. Furthermore, chronic pain management in the elderly should be combined nonpharmacological such as cognitive-behavioral therapy and pharmacological treatment in order to increase efficacy of pain control. Pharmacological management for chronic pain is composed of 3 categories including nonopioid analgesics, opioid analgesics, and adjuvant medications. The strategies of pharmacological treatment in the elderly are consideration of start with a low dose and slow titration. Moreover, physicians and pharmacists should be aware of drug-drug interactions, drug-disease interactions, as well as adverse drug reactions and events during treatment.  

scholarly journals Pain assessment and registration in medical oncology clinics: operationalised through the lens of health care professionals and patients

2021 ◽  
Vol 4 ◽  
pp. 86
Author(s):  
Laserina O'Connor ◽  
Aileen Hassett ◽  
Noeleen Sheridan
Keyword(s):  
Pain Management ◽  
Cancer Pain ◽  
Cancer Treatment ◽  
Pain Assessment ◽  
Health Care Professionals ◽  
Healthcare Professionals ◽  
Medical Oncology ◽  
Pain Treatment ◽  
Self Report ◽  
Common Symptom

Background: Pain is a common symptom in patients who survive cancer and in those who live with progressive advanced disease. Systematic screening and documentation of pain are necessary to improve the quality of cancer pain treatment, because a key pain-related barrier is that patients are reluctant to discuss pain, due to fear that reporting pain will distract the healthcare professional from their cancer treatment. Methods: This study adopted an explanatory sequential mixed-methods design. Data collection incorporated three strands. The first strand involved a quantitative enquiry in which medical chart reviews of patients (n=100) attending the medical oncology outpatient clinic were examined. The second qualitative strand comprised of semi-structured interviews with patients (n=10) attending that service. The third strand was qualitative and consisted of focus group discussions with healthcare professionals (n=12). Results: All 100 patients had cancer. The quantitative findings confirmed the suboptimum assessment and subsequent recording of patient’s pain, that seemed to afford a reality check for all healthcare professionals. For patients, the outcomes of the anti-cancer treatment were their priority, and pain was perceived as inevitable, being associated with a cancer diagnosis. There were multifaceted complexities voiced amongst healthcare professionals associated with balancing the benefits and harms aligned with treating cancer pain. Conclusions: Pain assessment in medical records was not systematically recorded by healthcare professionals. Patients were reluctant to self-report pain during their medical oncology outpatient review. The expectation that patients will self-report pain can be accommodated by healthcare professionals if a personalized pain goal is part of the cancer pain management plan during each clinical encounter. Healthcare professionals reported a need to take distinct responsibility for supplementing their dearth of knowledge, skills and beliefs regarding assessing and managing patients’ cancer pain. Optimal pain management stems from an interprofessional approach that was applied in this study design.

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