WELLNESS AND AGING
by Sheldon Ornstein, Ed.D, RN, LNHA
Thoughts on Pain in the Elderly
The elderly are a special group of people who have amassed a reservoir of experience throughout a lifetime of interaction with humanity and life circumstances. At the peak of their existence, they are able to confront and deal with whatever issues impact their activities of daily life. Life does not, however, remain static; it is an ever changing process. Life brings changes for the aged and for the young as well.
Even with this change in age, individuals have similar needs and desires as their younger counterparts. Several assumptions have been made concerning the elderly, the worst of which is the tendency to believe that elderly people do not experience the same intensity of pain as everyone else. As a result of this unfounded notion, the elderly person, in a number of repetitive instances, suffers prolonged pain.
This observation is echoed by researchers who found that pain in our elderly population is under-treated. Caregivers may think that the pain felt by older adults is a “natural” occurrence of the aging process.
A review of the literature shows that 50% of cancer cases in the United States occur in patients and elderly individuals in our communities 65 years and older and that up to 80% of these patients suffer moderate to severe pain.
It has also been well documented that culture and tradition play pivotal roles in the treatment modality of pain in the older adult. Culture serves as a guide and dictates behavior of the individual in matters of health and sickness. The type of pain suffered by the older adult may result from a direct insult to the body such as a fall or may be due to a chronic ailment such as arthritis.
Also, as caregivers, a major concern must be given to a special type of pain in the elderly and that is the feeling of unrelieved apathy. The consequences of this pain stretches far and wide; pain compromises activities of daily living, fosters dependence on others and reduces significantly the individual’s quality of life.
The older adult may also have difficulty with expressing pain and this becomes even more critical where cognitive impairment is factored in. In recent years, pain has been given renewed attention and is now known as the fifth vital sign.
As we age, the anticipation of pain may become crucial and our response to it may be magnified. Nothing mystical exists to identify pain or its intensity in the elderly individual or any other patient for that matter.
Therefore, family caregivers as well as professionals must be prepared to tune into signals from the older person which can result in valuable clues that can be identified and cared for.
Holistic treatment (ie: mind, body spirit) may also be incorporated with appropriate medical intervention.
Consider, when you enter any kind of facility, you are given a Patient’s Bill of Rights which informs you that you are entitled to pain management. Exercise your right! And if you feel your pain is not being addressed adequately, request a meeting with your physician, nurse and/or pain management consultant. Insist on a medication review, a dosage review, and a description of your pain. If you are living at home, address the same issue with your Health Care Provider.
Remember, the individual is cared for not just for the pain experience but for that elderly person’s life span perspective that views the impact of environment as people age.
“Success is a journey, not a destination.”
This is the first in a series of monthly columns on the subject of Aging in America.
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