Management of chronic pain in older persons

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Zahra Dehghanim and Azadeh Maraghian Mohammadi

Shiraz University of Medical Sciences, Iran

: J Nurs Patient Care

Abstract

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The elderly population comprises the fastest growing segment of the world's population. As patients age, the incidence and prevalence of certain pain syndromes increase. Pain may be underreported as some elderly patients incorrectly believe that pain is a normal process of aging. Chronic geriatric pain may be defined as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage, for persons who are either aged (65 to 79 years old) or very aged (80 and over) and who have had pain for greater than 3 months.” Clinical manifestations of persistent pain are often complex and multifactorial in the older population. Even the perception of pain may differ from that perceived by those of less advanced years. Issues of physical accessibility to treatment, cost of drugs, the presence of coexisting illness, the use of concomitant medication, and the ability to understand the complaints of the patient who has cognitive impairment are only some of the factors that contribute to the complexity of the situation. A multidisciplinary approach is recommended to investigate all possible options for optimal management: (1) pharmacotherapy (most commonly employed), (2) psychological support, (3) physical rehabilitation, and (4) interventional procedures. To maintain freedom from pain, WHO recommends (1) administration of drugs “by the clock” (eg, every 3–6 hours), (2) medication by mouth individualized for the patient, and lastly (3) following the “analgesic ladder”. Because pain is a complex sensory and emotional experience, psychological modalities should be employed in the pain management model.

Biography

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Zahra Dehghani has completed her Master Degree from Shiraz University of Medical Sciences in Shiraz-Iran. She is working as faculty member in nursing and midwifery school for more than 20 years. She participated in many international and national conference and published some paper.

E-mail: mersadgh@yahoo.com