Older People and Pain
~ By Patricia Kay Youngson, RN ~
Pain is common in older people. In fact, people over 60 are twice as likely to be in pain as people under 60. And the elderly are in the group most under-treated for pain. (This includes women, children, ethnic minorities, and people of a lower education and income.) After surgery it is common for the elderly to receive less pain medication than younger patients. Studies show that even when adequate medication is ordered only about a fourth is administered by nurses.
Why would this be? For one thing there can be a belief that the elderly do not experience as much pain as younger people. This is false. In fact, older people probably have a lower pain pain threshold from having previous experiences with severe pain.
Older adults may tend to under report their pain because of the desire to be “strong”, valuing stoicism. Caregivers may assume that they are not in pain if they don’t report it. Also caregivers my feel that the opiates are too dangerous for the elderly, fearing drug interactions and side effects.
It is true that the older body clears drugs less effectively and possible side effects are confusion, sedation, respiratory depression, and constipation. Except for constipation, all of subside in a few days. The solution is to monitor the patient carefully. Constipation can be averted by starting a stool softener and laxative at the same time the pain medication is started–certainly not to wait until a person is constipated. Basically, besides monitoring carefully, the rule is start low and go slow.
Inadequate acute pain control delays healing and results in many other negative physical and emotional effects as well as suffering. In addition, inadequately controlled acute pain can result in chronic pain.
Here is wishing you good pain control.
Patricia Kay Youngson RN, Counselor, specializing in chronic pain and presurgical consultations. E-mail: firstname.lastname@example.org. Website: patriciak.com