Pain management of older adults after discharge from outpatient surgery

Older adults manage their pain at home after outpatient surgery. Yet the experience and management of postoperative pain outside the hospital is largely unknown. The purpose of this study was to examine older adults' experiences of postoperative pain and their methods of pain management after discharge from outpatient surgery. A telephone-based interview of 93 older adults (ages 60-84) showed that pain intensity reached a level of 5 (0 to 10 scale) for 66% of participants on the first morning and for 42% on the third evening after discharge. Pain interfered with activities for almost one-fourth of the participants. Reasons for high pain intensity scores included improper and inadequate dosage of pain medication. More than half of the participants chose to take only one pain tablet at a time and 66% waited until their pain intensity reached a rating of 5 or above before taking their analgesic medication. The participants who took pain medications at higher levels of pain intensity reported taking larger amounts of medication but receiving less pain relief. This finding substantiates the idea that it takes a larger dose of pain medication to decrease severe pain. Pain management instructions did not make a difference in the way pain was managed. Overall, findings indicate that older postoperative patients are not adequately medicating themselves for pain after discharge. Furthermore, when participants were asked, "From this list of nonpharmacologic activities, which activities helped relieve pain?" the most frequently selected answer was "to stay still or not move." This finding requires further investigation to determine if older adults are using immobility as a way to control their pain.