Pain is a symptom that signals distress in virtually every population at every age. However, among older adults, a higher incidence of chronic conditions places them at increased risk for pain. In addition, there are many barriers to effective pain management in this age group. Nurses, physicians, psychologists, social workers, spiritual advisors, alternative and complementary therapists, and other allied health professionals are among the individuals who may assist clients in the assessment and treatment of pain, and they are responsible to accurately assess and appropriately treat this symptom.
Pain exists within the context of a culture, as well as within personal, physical, and psychological history. Its treatment, therefore, should be multidisciplinary. Pain is not part of growing old. Many healthcare providers see aging adults only when they are in need of intense medical or nursing care, but these individuals do not represent “normal” aging. While it is not part of normal aging, pain is a common problem among older adults (Meiner, 2014).
Pain research and literature on pain management have greatly increased during the last decades but have been limited primarily to young clients and those with cancer in acute care settings. Pain is often still unrecognized and undertreated in the elderly individual. Nurses may tend to inadequately manage pain because of a fear of patients’ addiction and complications from analgesic medications.
Undertreated pain places individuals at risk. It can (American Pain Society, 2018; Meiner, 2014; Pasero & McCaffery, 2011)
- increase release of cortisol, epinephrine, growth hormone, catecholamines, and glucagon,
- inhibit the immune system,
- impair recovery from injury or procedures,
- result in sleep disturbances,
- increase the risk of premature death,
- increase oxygen demand, cardiac workload, heart rate, hypertension, and coagulation,
- increase the experience of fear, anxiety, anger, or depression,
- increase respiratory dysfunction,
- decrease gastrointestinal motility,
- increase muscle spasms, fatigue, immobility,
- decrease urinary output,
- reduce cognitive function,
- increase mental confusion,
- diminish quality of life, and
- increase confusion.
Pain in the cognitively impaired older adult and pain as it relates to gender are both relatively new fields of inquiry. Elderly people (usually defined as those over the age of 65) are the fastest growing segment of the U.S. population. Their care offers unique challenges to healthcare providers and requires that special attention be paid to pain management, cognitive impairment, end-of-life issues, and palliative (comfort) care vs. cures.