Chronic Pain Management in the Elderly
How can we tell when they are hurting?

Second in a series of articles that will address chronic pain in the elderly

March 1999

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

I promised myself when I hit forty that I was going to make it a point to grow old gracefully. Taking good care of myself by eating the right foods, exercising and visiting my doctor on a routine basis. Seemed like a good plan. What I did not count on were the little aches and pains that go along with the aging process. So now when I visit my doctor, I take time to explain these new found ailments that seem to arrive at each annual visit. He listens very patiently as I describe the very subtle arthritic pain symptoms I experience when I run a few miles trying to keep up with my school-age children. I am fortunate that I am still at an age when I can detail these experiences and find there are remedies available. Many of our elders are not as fortunate. Because the elderly characteristically underreport pain, thorough pain assessment in these people is especially important.

Formal pain assessment should be routine. Such formal assessment can be carried out with a very simple assessment tool that evaluates pain intensity, quality, location, and duration. However, formal pain assessments may not be sufficient for those with speech, hearing or cognitive deficits or who fear reporting pain. Close observations of behavior may reveal expressions, movements, and activities indicative of pain. Here are some examples:

• Facial wrinkling, tightly closed, widely opened, or blinking eyes.
• Grimacing
• Crying or moaning
• Aggression- biting or hitting
• Increase in body movements
• Guarding an area of the body
• Decrease in social interaction or common routines. Don't let pain stop you from enjoying your grandchildren!
• Increased rest periods
• Irritability, greater confusion.

Let's make a conscious effort to look out after each other. Chronic pain is not necessarily a direct result of the aging process. If you or someone you care about is suffering from chronic pain, ask your family physician about pain management specialists. There are many new treatments available to alleviate pain in the elderly. Tune in to the Senior Connection Radio show to hear the experts in pain management. Next months article will focus in on the many treatment options available at a location near you. If you are on the internet, key in to seniors-connection.com, where you can post specific questions on pain management treatments.

I can tell you, growing old gracefully is one thing. Doing it pain free is far more important!