Chronic Pain Management in the Elderly
First in a series of articles that will address chronic pain in the elderly

February 1999

Lori J. Schmitt R.N
Co-host of The Senior Connection Radio Show
Manager of Marketing, Cleveland Clinic Pain Management Centers

The incidence of pain in people over 60 is twice that of people under 60. According to TT. Fulmer in a text entitled Geriatric Nursing, elderly patients may be more likely to experience pain and less likely to report it. Cancer, musculoskeletal disease, and vascular disease are some of the conditions responsible for the incidence of pain in older people. Some of the reasons why these people are less likely to report pain include the following.

• Fear of "bothering" or "annoying" family members or those responsible for their care.
• Inability to report clearly, because of speech, hearing, cognitive deficits or language barriers.
• Fear of facing pain, because it could lead to more serious illness or perhaps even death.
• Concerns about drug therapy and limitations to "mix medications".
• Belief that pain has to be endured because of the aging process.

According to the Agency for Health Care Policy and research, (AHCPR): "The elderly should be considered an at-risk group for the undertreatment of cancer pain because of inappropriate beliefs about their pain sensitivity, pain tolerance, and ability to use opioids. Elderly patients, like other adults, require aggressive pain management and assessment."

Cleveland is rich in health care professionals who have committed their lives work to the treatment of chronic pain. Locally the many pain management centers of the Cleveland Clinic Foundation offer many types of alternative pain management options for the aging population. Over the next few months, we will be discussing many of these options on the Senior Connection Radio show. We will include many health care professionals that have successfully treated many greater Clevelanders. Next months article will focus on the assessment of pain in elderly patients.

Tune in on Tuesdays, for the Senior Connection radio Show from 12:30-1:45pm to learn more about chronic pain management in the elderly.