article on pain of elderly people
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A number of reasons have been highlighted which seek to explain why pain is poorly managed in older adults compared to their younger counterparts. There is a lack of evidence regarding acceptable treatment for older adults (13) as trials tend to focus upon younger adults and it is acknowledged that older adults are under-represented in pain clinics and pain management programmes (14). Other reasons cited include the fact that pain is assumed to be part of ageing, older adults assume that health care professionals will “know” when they are in pain and of course, with increased age comes the increased likelihood of co-morbidities which can complicate diagnosis and cause unpleasant interactions with medications thus affecting concordance. With increasing age and the potential vulnerability comes the risk of cognitive impairment which can make diagnosis more difficult. A recent qualitative study sought to identify some of the barriers to reporting pain held by residents living in a number of care homes within one district (15). A series of semi-structured interviews were conducted with residents who were mildly / moderate cognitively impaired. The interviews identified a number of key themes as follows:
A reluctance to report pain/acceptance that pain is normal and low expectations of help from medical interventions. Many residents when interviewed were in pain, but when asked why they had not reported the pain to the staff, they commented that there was no need to, as there was probably nothing that anyone could do.
Fear of chemical/pharmacological interventions. Many of the residents commented that they were fearful of using pharmacological interventions, and they would prefer to manage without, or that nothing seemed to help.
Age Related Perceptions of Pain. Not only were the older age group (>80) reluctant to take analgesics, but they were also reluctant to actually admit that they had pain. The residents under 75 years were more willing to voice their pain, and consequently to take analgesic drugs.
A reluctance to report pain/acceptance that pain is normal and low expectations of help from medical interventions. Many residents when interviewed were in pain, but when asked why they had not reported the pain to the staff, they commented that there was no need to, as there was probably nothing that anyone could do.
Fear of chemical/pharmacological interventions. Many of the residents commented that they were fearful of using pharmacological interventions, and they would prefer to manage without, or that nothing seemed to help.
Age Related Perceptions of Pain. Not only were the older age group (>80) reluctant to take analgesics, but they were also reluctant to actually admit that they had pain. The residents under 75 years were more willing to voice their pain, and consequently to take analgesic drugs.
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