Pain Management In The EIderIy

What is pain?
Pain Management In The EIderIy Care Guide
O Pain Management In The EIderIy
O Pain Management n The Elderly Aftercare nstructions
O Pain Management n The Elderly Discharge Care
O En Espanol
O Pain is an unpleasant feeling and emotional experience related to injury or damage to the
body. This is one of the most common complaints that remains poorly treated in the elderly. An
older person may be called an elder. There is no set age for an elder, but it may be defined as
when a person retires at the age of 60 or 65 years old. n certain countries, it may be when a
person physically cannot do his usual family or work roles anymore.
O As you become older, different changes occur in your body and how it works. Elder people
may have more health problems but this does not make pain a normal part of aging. Pain may
be a sign that something is wrong with your body. The body contains special cells that receive
signals when there is damage or injury to the body. These cells send a message to the brain.
When the brain receives the message, you will feel pain.
What are the types of pain?
O .ute pain: This occurs when the body tells the brain that something is wrong, such as an
illness or injury. t comes on suddenly and does not last for a long period of time. This usually
goes away as your body heals, but may lead to chronic pain if left untreated.
O Chroni. pain: This type of pain persists or grows worse over a long period of time. t may last
for months or years due to a chronic (long term) condition. t may be pain that remains after
you have recovered from an injury or illness. Chronic pain may persist even if caregivers have
given you medicines or treatments. t may not always be present but still may cause problems
with your daily activities.
What .auses pain in the eIderIy?
Pain is often caused by more than one problem. These problems may include damage to the nerves
or tissues, such as skin, muscles, and internal organs. Sometimes, there is no clear or exact cause
of pain. Any of the following may cause or trigger pain:
O Diseases, such as cancer, arthritis, migraines, and back problems.
O Physical injury, such as with surgery, accidents, or falls.
What other things shouId eIderIy peopIe know about pain?
All pain should be treated and can almost always be relieved. Elder people often have many
questions and fears about pain. These fears may make them not seek treatment to relieve their pain.
The following are important things that you should know about pain and its management:
O Do not be ashamed to tell your caregivers about what you are feeling.
O Controlling your pain is part of the whole treatment for your disease.
O Pain medicines are not only for terminal diseases such as cancer and will not make you
doped up or lose control.
O Side effects from medicines can often be prevented and managed properly.
ow .an .aregivers know if an eIder is in pain?
Elders who can talk clearly may tell exactly the location, intensity (how bad), and even the duration
of the pain. Some elders who have certain diseases or injuries may have trouble saying what they
really feel. These diseases may include dementia (memory problem), brain damage, or a stroke.
You may even deny that you are having pain to show courage or escape treatment. The following
are common signs that may tell caregivers that you are in pain:
O Crying, moaning, frowning, or sighing.
O Feeling sad, depressed, hopeless, aggressive, or angry most of the time.
O Noisy breathing, calling out, or asking for help.
O Not changing positions very often to avoid pain, or positioning yourself in a way that it will not
hurt.
O Poor appetite and eating habits, or sleeps more or sleeps less than usual.
O Pulls the part of the body that is hurting or gets upset at being touched.
O Restlessness, cannot get comfortable, and moves around a lot.
ow is pain diagnosed?
t may be easier to diagnose your pain if you have a pain diary. A pain diary helps track pain cycles,
and makes you more aware of when and how the pain may start and end. Elder people may often
describe pain as slow, dull and achy. No tests are available to diagnose pain. Caregivers may first
look for possible causes of your pain. The diagnosis of pain is based on how long and how often you
have your symptoms. You may also need any of the following to check how much pain you have or
find its cause:
O Physi.aI examination: Your caregiver will look for painful areas during a physical exam. He
may touch, press, or stroke different places on your body.
O Imaging tests: Caregivers may suggest that you have different imaging tests to look for the
cause of your pain. These may include x-rays, computed tomography (CT) scan, and magnetic
resonance imaging (MR).
O Pain s.aIe: These are special tools that can help caregivers measure how much pain you feel.
There are many pain scales that include numbers or cartoon faces with different expressions.
Your caregiver may ask you to rate the pain on a scale of 0 to 10.

O
O $timuIation tests: Stimulation tests tell exactly which nerves or muscles are affected by pain.
ow is pain treated?
The aim of pain management in the elderly is to relieve pain and improve your quality of life.
Controlling pain may allow you to work or do your usual activities. Caregivers may need to treat your
pain and its cause by giving you medicines. These medicines work by blocking pain signals going to
the brain or by changing how the brain interprets pain signals. Almost all types of pain can be
controlled. Work together with your caregiver to decide the best pain control treatment for you. You
may need one or more of the following:
O naIgesi.s: This is a group of medicines that includes most painkillers.
4 ar.oti. anaIgesi.s: These medicines, which include morphine, contain opium. A
narcotic analgesic is used for moderate to severe (very bad) pain. This may be used to
control cancer pain or after having surgery or other procedures.
4 on-nar.oti. anaIgesi.s: These work by changing the way the body senses pain and
by cooling the body. Non-narcotic analgesics are used to relieve mild to moderate pain
from headaches, muscle aches, colds, and fever.
4 on-steroidaI anti-infIammatory drugs: This family of medicine, also called NSADs,
helps decrease pain and inflammation (swelling). Some NSADs may also be used to
decrease a high body temperature.

O nesthesia: This numbing medicine is used to control pain and make you comfortable during
a procedure or surgery.
What other medi.ines may be given to heIp you with your pain?
Your caregiver may also need to treat the cause of your pain. Pain caused by infections may be
treated with antibiotic or anti-viral medicine to kill the germs. Pain from cancer may be treated with
chemotherapy or radiation therapy. Your caregiver may suggest other medicines to help control your
pain, or prevent the side effects of pain medicines.
O nti-anxiety medi.ine: This medicine may be given to help you feel less nervous and more
relaxed.
O nti.onvuIsant medi.ine: Anticonvulsants are given to control seizures.
O nti-depressants: These medicines may be used to help decrease or prevent depression.
Anti-depressants lift up your mood and may help relieve your pain.
O Mus.Ie reIaxers: This is medicine to help your muscles relax. When your muscles relax, you
may move more easily and have less pain.
O #adiopharma.euti.aIs and biphosphonates: Radiopharmaceuticals and biphosphonates
help decrease cancer growth, pain, and inflammation that happens when cancer gets inside
bones.
O $edative: A sedative medicine may be given to help you stay calm and relaxed.
O $teroids: This medicine may be given to decrease inflammation.
What are other ways of treating pain?
Aside from medicines, treatment of pain may include any of the following:
O CompIementary and aIternative therapies:
4 .upun.ture: Acupuncture is a treatment based on a belief that fluids flow through
channels in our bodies. Caregivers insert very thin needles just under your skin. This is
believed to open the channels, allowing fluids to flow better. This treatment may
decrease pain and improve healing. Always see a caregiver for acupuncture. Do not try
to give this treatment to yourself.
4 romatherapy: Essential oils, extracts, or fragrances from flowers, herbs, and trees are
used. These may be smelled or applied for massage, facials, body wraps and baths.
Aromatherapy helps you relax and relieve stress.
4 Chiropra.ti. therapy: Pain is treated by caregivers who move body parts in certain
ways. This may include parts such as the spine (backbone) and joints. Joints are places
on the body where two bones meet, such as the elbows or knees.
4 ietary suppIements: Vitamins, minerals, herbs, or other botanicals (plants) may be
given to ease pain.
4 Mind-body therapies:
iofeedba.k training: Biofeedback is a special way to control how your body
reacts to things like stress or pain. The first step in this training is to use electrodes
(wires) to monitor your body responses. These electrodes are placed on different
parts of your body, such as your chest. The electrodes are attached to a TV-type
monitor which gives a paper tracing of your heart beating. You will learn how to
control body changes, such as slowing your heart rate, when you become upset.
ypnosis: This is done by putting you in a trance-like (sleep-like) state. Your
caregiver then gives you suggestions that may help you heal yourself.
Meditation: This therapy teaches you how to focus inside yourself. The goal of
meditation is to help you feel more calm and peaceful.
#eIaxation therapy: Relaxation therapy teaches you how to calm your body and
mind. The goal is to feel less physical (body) stress and have less emotional (mind)
stress.

O Edu.ation: t is important that you know and understand your condition, treatment, and care.
This will allow you to tell your caregivers how you really feel about your pain. You may also talk
about your concerns, such as becoming addicted (dependent) to pain medicines. Your
questions or fear of the side effects and costs of medicines and other treatments may also be
explained. Pain may be decreased or relieved by believing that you can control and handle
pain.
O EIe.tri.aI stimuIation: A special device is used that sends mild and safe electrical signals.
These signals decrease your pain when used over a painful body part.
O eat and .oId appIi.ation: Some types of pain are decreased by using warm or heat packs
while others improve with cold. Your caregiver will tell you if warm or cold packs, or both used
alternately, will help your pain. Taking a warm bath may also help your muscles relax. A cool
shower on a very hot summer day may also relax tense muscles.
O #ehabiIitation: This program may include physical and occupational therapy. With physical
therapy (PT), special exercises are used to help your body get stronger and heal faster.
Caregivers may suggest that you use special assistive devices, such as a wheelchair, braces,
crutches, a cane, or a walker. Using these devices may decrease stress and strain on your
back and muscles. Massage and physical therapy can be even more effective if you also use
guided imagery, breathing exercises, or music. Occupational therapy (OT) uses work, self-
care, and play activities to help you in your daily life. These include special skills for bathing,
dressing, cooking, eating, and driving.
O $urgery and other pro.edures: Your caregiver may do surgery to help relieve your pain. He
may need to remove the whole or a part of a tumor. He may also cut nerves or remove joints
that may be causing your pain. He may use ultrasound, radio waves, thermal (heat), or laser
therapy to relieve your pain. Ask your caregiver about these different treatment options for
cancer pain.
What might happen if pain is not treated?
Pain may affect many areas of your life. t can affect your appetite (ability or desire to eat), how well
you sleep, your energy and your ability to do things. t can also affect your mood (how you feel about
things) and your relationships with others. t is sometimes hard to find the cause of pain. You may
feel that it is impossible to get rid of your pain. This can cause a cycle of suffering, sleeplessness
and sadness. f caregivers can help control your pain, you will suffer less and enjoy your life more.
Where .an I find more information?
Having pain when you are an elder may be hard for you and your family. Accepting that you have
pain may be hard. You and those around you may feel sad, frightened, and anxious. These feelings
are normal. Talk to your caregiver, family, or friends about your feelings. Contact the following for
more information about pain:
O American Academy of Family Physicians
11400 Tomahawk Creek Parkway
Leawood , KS 66211-2680
Phone: 1- 913 - 906-6000
Phone: 1- 800 - 274-2237
Web Address: http://www.aafp.org
O National Chronic Pain Outreach Association
PO Box 274
Millboro , VA 24460
Phone: 1- 540 - 862-9437
Web Address: www.chronicpain.org
Care greement
You have the right to help plan your care. Learn about your health condition and how it may be
treated. Discuss treatment options with your caregivers to decide what care you want to receive. You
always have the right to refuse treatment.
Copyright 2011. Thomson Reuters. All rights reserved. nformation is for End User's use only and
may not be sold, redistributed or otherwise used for commercial purposes.
The above information is an educational aid only. t is not intended as medical advice for individual
conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical
regimen to see if it is safe and effective for you.