The Link Between Pain & Geriatrics

Geriatric patients suffering with chronic pain are often undertreated, and as the elderly population continues to rise, issues regarding pain in the geriatric population is likely to increase. Therefore, pain management in elderly patients is an ongoing challenge that primary care physicians and other health officials must face by improving the quality of care.

The improper assessment of pain, the underreporting of pain by elderly patients, the debate about addiction and opioids, and the normal relationship between pain and aging are common reasons that there is lessened treatment for elderly patients suffering with pain. Physicians often blame undertreatment on improper training and pain assessment, along with the hesitation to prescribe opioids. As a consequence of undertreatment, many patients have suffered through mental illness including depression, anxiety, and social isolation. Patients have also faced cognitive impairment, immobility, and sleep disturbances.

Another important aspect of pain experienced by geriatric patients to understand is that their pain perception may be different than that of other age groups because of the atypical symptoms of diseases presented in older individuals, and the medications often used to treat the atypical symptoms in these patients can often have negative side-effects.

It may be difficult to assess pain in older individuals because they often see a correlation between pain and aging. Elderly patients often fear that there may be a more serious underlying problem that they want to avoid. They also tend to accept pain as a punishment as a result of their past actions. Thus, if you or someone you know is experiencing pain, it is important not to make assumptions, and to seek a physician to assess the pain.

To increase the efficacy of pain assessment doctors, patients, and families must understand that symptoms presented may be atypical. Physicians should also regularly ask about pain in their geriatric patients because it has been characterized as a vital sign. Pain can be assessed, even in patients who are cognitively impaired, using screening tools and questioning. For example, a verbally administered zero to 10 scale, 10 being the worst possible pain, is effective in measuring the level of pain in geriatric patients. Older patients and patients with cognitive impairment may have difficulties using this scale but there are other tools that can be used to assess the levels of pain including a visual analog scale, numerical scale, pain thermometer scale, and pain faces scale. Additionally, pain logs should be encouraged by physicians.

These are simple measures that can be taken to improve the effectiveness of pain treatment in geriatric patients. It is important to be sensitive to, and educated on, the matter because pain in the elderly may often present differently that pain in other age groups. To conclude, communication between physicians, patients and families,  proper training, and education on pain in the geriatric population are key factors that can help improve pain treatment in elderly patients.

Samantha Scerbo