Caring for Older AdultsExperiencing Pain among Older Adults Flashcards
Exam 3
Pain: A Complex Phenomenon
What is the greatest threat to comfort?
Pain is greatest threat to comfort
Pain: A Complex Phenomenon
What kind of phenomenon is pain?
Pain: biopsychosocial phenomenon:
Pain: A Complex Phenomenon
Pain: biopsychosocial phenomenon: How is it explained?
An unpleasant sensory and emotional experience associated with actual or potential tissue damage
Pain: A Complex Phenomenon
Pain: What is pain? What does it rely on?
Pain is subjective and relies on person’s perception:
Pain: A Complex Phenomenon
Pain: Who does it exist for?
Whatever the person experiencing it says, it is existing whenever she or he says it does
Unique aspects of pain in older adults
Who is pain predominantly in?
Predominant in older population, but relatively few studies on pain have focused on this potentially vulnerable population.
Unique aspects of pain in older adults
What is there a growing recognition in?
Research gaps in aspects of pain and older adults-There has been a growing recognition of the need for better pharmacologic management of chronic pain among older adults.
Unique aspects of pain in older adults
What is there a lack of when is comes to pain studies?
Lack of evidence-based information, misconceptions, and misinformation
Unique aspects of pain in older adults
What is it commonly believed about pain in older adults? What does this result in?
It is commonly believed that elderly persons are less sensitive to pain and that experiencing pain is part of the aging process, but these assumptions result in undertreatment of pain.
Unique aspects of pain in older adults
Age-related changes that affect pain:
What is altered?
Pain process is altered
Pain perception and the older adult
Unique aspects of pain in older adults
Age-related changes that affect pain:
What changed occur?
Age-related changes in pharmacokinetics and pharmacodynamics AND increased risk for adverse effects
Unique aspects of pain in older adults
Age-related changes that affect pain:
How does pain present?
Atypical presentation of pain symptoms
Unique aspects of pain in older adults
Age-related changes that affect pain:
Who is less likely to report pain?
Older adults less likely to report pain
Unique aspects of pain in older adults (cont.)
How many types of locations and pain?
several types of locations and pain
Unique aspects of pain in older adults (cont.)
Where does pain occur?
Prevalence and causes -60% of older adults in community setting and 83% -93% of those in nursing homes experiencing persistent pain.
Unique aspects of pain in older adults (cont.)
What is the most common pain?
Musculoskeletal pain is most common
Unique aspects of pain in older adults (cont.)
Who reports a higher prevalence of pain? Who is likely to be undertreated for pain?
Women consistently report a higher prevalence of persistent pain than men
Nociception
physiologic process leads to perception of noxious stimulus as painful.
Nociception:
Nociceptive pain arises from what?
Nociceptive pain arises from mechanical, thermal, or chemical noxious stimuli.
Nociception:
Nociceptive pain - what are the four processes?
Four processes:
transduction,
transmission,
perception,
and modulation.
Neuropathic pain: What is it?
abnormal processing of sensory stimuli by the central or peripheral nervous system
Neuropathic pain:
How can it occur?
Can occur in the absence of immediate tissue damage or inflammation.
Somatic nociceptive pain:
pain that originates from the bones and soft tissue, and is often caused by osteoarthritis.
Chronic pain:
has been present for 3 months or longer.
Visceral pain:
Is associated with disorders that can cause generalized or referred pain and is and is described as deep and aching.
Definitions and types of pain (Cont.)
Acute pain: What is it?
Acute, noncancerous pain experienced late in life is usually episodic in nature and is temporary and time limited (less than 3 months)
Definitions and types of pain (Cont.)
Acute pain: What are examples?
Examples include
postoperative,
procedural,
or posttraumatic.
Definitions and types of pain (Cont.)
Acute pain: What is it considered?
Considered a universal experience for all older adults at some point
Definitions and types of pain (Cont.)
Acute pain: How is it often?
Often is superimposed on a preexisting chronic pain
Definitions and types of pain (Cont.)
Acute pain: How does the pain occur?
sharp, immediate pain from injury to tissue
Definitions and types of pain (Cont.)
Acute pain: What is it responsive to?
and responsive to analgesics
Definitions and types of pain (Cont.)
Acute pain: What are examples of things used to treat severe acute pain?
Prescription opioids (like hydrocodone, oxycodone, and morphine) are one of the many options for treating severe acute pain.
Definitions and types of pain (Cont.)
Persistent (chronic) pain: What is it?
Continues for prolonged period; may or may not be associated with a recognizable disease process.
Definitions and types of pain (Cont.)
Persistent (chronic) pain: How long is it?
lasts longer than 3 to 6 months or beyond the expected time of healing
Definitions and types of pain (Cont.)
Persistent (chronic) pain: How can it develop?
May develop insidiously as a disease progresses or may be a sequela to an episode of acute pain
Definitions and types of pain (Cont.)
Persistent (chronic) pain: What percent of the community is thought to have chronic pain?
The pain of more than 75% of those living in the community is thought to be chronic.
Definitions and types of pain (Cont.)
Persistent (chronic) pain: What is the realistic goal for treatment?
For those with persistent pain, the only realistic goals may be reducing the sensation and minimizing its effect on the person’s quality of life and independence.
Which condition is the most common cause of persistent pain in the older adult population?
A. Fibromyalgia
B. Arthritis
C. Polyneuropathy
D. Hip fracture
B. Arthritis
Arthritis, the most common cause of persistent pain in the older adult population, currently affects between 49% and 59% of older adults, or more than 20 million people
Barriers to Pain Management in Older Adults
What are the three major groups
Health Care Professional Barriers
Health Care System Barriers
Older Adults and Family Barriers
Barriers to Pain Management in Older Adults
Health Care Professional Barriers: What is lacking? What is there a concern of?
Lack of education regarding pain assessment and management
Concern regarding regulatory scrutiny
Barriers to Pain Management in Older Adults
Health Care Professional Barriers: What is there a belief of?
Belief that pain is a normal part of aging
Belief that cognitively impaired older adults have less pain Personal beliefs and experiences with pain
Barriers to Pain Management in Older Adults
Health Care Professional Barriers: What is there an inability of?
Inability to accept the person’s report of pain without “objective” signs
Barriers to Pain Management in Older Adults
Health Care System Barriers
Cost
Time Policy regarding opioid use Systemic bias
Barriers to Pain Management in Older Adults
Older Adults and Family Barriers: What is there concern?
Concern that the person will not be believed
Barriers to Pain Management in Older Adults
Older Adults and Family Barriers: What are their fears?
Fear of being a “bad patient” if complaining
Fear of the meaning of the pain, e.g., that the person has cancer Fear of addiction Fear of side effects of treatments Fear of medication side effects
Barriers to Pain Management in Older Adults
Older Adults and Family Barriers: What are concerns?
Concern that the pain is not important to the health care provider/nurse
Concern that the pain is not important to the health care provider/nurse
Barriers to Pain Management in Older Adults
Older Adults and Family Barriers: What are limitations?
Financial limitations
Barriers to Pain Management in Older Adults
Older Adults and Family Barriers: What is the belief?
Belief that pain is a normal part of the aging
Belief that nothing can be done to adequately relieve pain
Barriers to Pain Management in Older Adults
Older Adults and Family Barriers: What coexists?
Coexistence of sensory or cognitive deficits