Relieving pain in the elderly

In 2000, people aged 65 and older made up 12.4 percent of the U.S. population. Between now and 2011, when the earliest-born of the baby-boom generation reaches that age, the nation will see a rapid growth in its senior citizen population. It has been estimated that pain occurs in from 45 percent to 85 percent of the geriatric population. Much of it is undertreated. Undertreated pain leads to other problems, including reduced quality of life, decreased socialization, depression, sleep disturbances, cognitive impairment, and malnutrition. For a population already vulnerable because of aging, the costs incurred by more frequent physician visits and hospitalizations can be financially devastating. Health professionals have a moral imperative to help elderly people in pain. The management of pain in geriatric patients can be complicated by the changing physiology that occurs with aging. Older people are also more likely to be living with multiple chronic diseases, necessitating many daily medications, thereby increasing the risk of negative drug-disease and drug-drug interactions. Older patients often show atypical presentations of pain. Depression can also play a role in the assessment and treatment of pain. For a number of reasons, many older people choose not to report their pain. Often they are afraid that they will be involuntarily hospitalized or subjected to invasive procedures if they report pain. Another important barrier to successful pain management is the fact that older people are often misinformed about the aging process, analgesics, pain management, and opioid addiction. Recognition of the problem of undertreatment of pain in older persons prompts the following question: What can be done to solve the problem? Educational in-service sessions improve the quality of patient care, because they improve providers' pain-management skills and attitudes. Patient education is also extremely important. When combined with teaching about self-management and coping strategies, it can improve the patient's pain management.