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Adopting Principles to Guide Pathways: The Best Model for Geriatric Pain Management
Corey B Simon1, Stephanie A Eucker2, Kenneth E Schmader3
1Department of Orthopaedic Surgery, Duke University School of Medicine, Duke Clinical Research Institute, Durham, NC, USA.
None:
Older adults experience the highest burden of chronic pain and pain-related disability. Existing pathways-multimodal, stepped, and stratified prove useful pieces but do not fully account for the complexity of geriatric care. This article argues for principles to guide pathways: explaining and adopting the biopsychosocial framework, applying it with nuance, addressing expectations, structuring limited time, communicating effectively, coaching rather than commanding, focusing on movement and function, and using safe pain-modulatory interventions. Together, these principles anchor individualized, patient-centered, and function-focused pain care.
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