Chronic pain is one of the most common conditions suffered by older adults. A National Institutes of Health (NIH) funded study indicates that nearly 53% of seniors, over the age of 65 experience persistent pain. Untreated or undertreated chronic pain can lead to a variety of negative consequences – avoidance of activity, reduced mobility, increased risk of falls, depression, anxiety, sleep disorders, and isolation.
As a caregiver, understanding of the unique characteristics of chronic pain in older adults as well as how to effectively assess and manage that pain can significantly enhance your loved one’s quality of life.
One of the biggest challenges of managing chronic pain is simply defining it.
Chronic pain is loosely defined as any pain that lasts beyond an expected healing period and may or may not be associated with an identifiable cause or damage.
As we age, it is increasingly common to suffer nerve pain associated with diabetes, shingles, cancer, or surgery. Chronic pain can also be the result of a variety of chronic diseases, like congestive heart failure, renal disease, and pulmonary obstructions. And finally, persistent pain could also be the result of joint and skeletal surgeries, arthritis, deteriorations, compressions, and fractures.
Probably one of the most shocking things about chronic pain in older adults is the underreporting and treatment. There are many reasons older adults might ignore chronic pain:
Caregivers play a significant role in finding chronic pain relief.
Caregivers can be the most useful source of information and advocacy for a multidisciplinary approach to pain assessment, diagnosis, and management. By engaging healthcare providers – physical therapists, physicians, psychologist, psychiatrist, and assisted living or in-home care providers – on behalf of your loved one, you can assure that their pain is reported and treated at an appropriate level to maximize the quality of life.
With a better understanding of chronic pain in older adults, how do caregivers go about treating these bothersome pains?
Your best opportunity for successful chronic pain relief is working collaboratively with your loved one’s healthcare providers.There are some general steps and knowledge that can guide you as you work with these professionals.
The first logical step is to accurately evaluate the pain and level of distress. But, for all of the reasons that older adults often don’t report or under-report pain, it can be equally challenging to evaluate.
Some of the most common methods for evaluating pain are assessment scales. These assessment tools can use simple descriptive scales, such as “describe your pain on a scale from none to agonizing”; numeric scales, like “describe your pain on a scale of 1 to 10, with 0 being no pain and 10 being unbearable pain; or visual analog scales, such as “point to your level of pain on this line from no pain to unbearable pain.”
Remember that some seniors may have trouble communicating about their pain because of cognitive or emotional impairment. This makes it important for caregivers to be active observers of their loved ones, especially when a cognitive decline or another condition might get in the way of them accurating describing their pain.
Some of the best evidence for heightened or chronic pain might be increased agitation, changes in functional status or body posture and gait, and social isolation. If you begin to notice any of these symptoms, it might be a good time to do a pain assessment with your loved one.
Pharmacologic (the use of drugs/medication) intervention is often used in the treatment and management of chronic pain.
When considering the use of pharmaceutical medications, it’s essential that you consult and collaborate with your loved one’s physician – the risk of adverse drug reactions in slightly higher in the elderly.
Doctors must be mindful of the age-associated differences in the chemistry and dynamics of pharmaceuticals as well as potential drug interactions with other drugs and diseases. One of the other challenges with pharmacologic pain management is the understanding that geriatric patients often require different dosages and concentrations of medications, but focused clinical trials are few. Therefore, carefully monitoring side effects and being as targeted as possible with treatment is essential. There is also a risk of addiction when using opioid-based drugs.
Many older adults may benefit for nonpharmacological approaches. These methods may help even if your loved one is taking medication for pain.
Some of the things to consider when pursuing nonpharmacologic treatment options:
Pain isn’t necessarily an inevitable part of aging and proactively preventing and addressing familiar sources of chronic pain can help you or your loved one live a more active and happier life.
The better educated you are about chronic pain management and therapy options, the better equipped you are to help yourself, or a loved one reduce or eliminate pain that shouldn’t be slowing you down.
The Area Agency on Aging 1-B offers a class to help you or your loved one learn to manage and cope with chronic pain. Our Chronic Pain Management classes are built on the Personal Action Toward Health (PATH) model, an evidence-based approach proven to help people learn to cope with chronic conditions. Our workshops meet once a week for six weeks and are held in community venues throughout our six-county southeast Michigan region. Classes are held in a small-group setting and are led by instructors who have often experienced chronic pain themselves, so they have a first-hand understanding of the challenges. This small group setting can also help you build a support community and learn from other people’s experiences.
With PATH Chronic Pain Management classes, you’ll learn how you can:
To find a class near you, call (833) 262-2200.