Pain is a common complaint amongst those who are over 65 years of age. In our experience, seniors are often un-treated or under-treated for pain. The barriers to effective pain assessment and management are many: from proper and timely assessment of pain to under-reporting by patients; from atypical manifestations of pain in the elderly to even misconceptions about tolerance or addiction to opioids. It is only a holistic and inter-disciplinary treatment of a proper regimen under a physician’s care that appropriate pain management can be provided to geriatric patients, with correct non-opioid, opioid, and other medications.
Many elderly adults and their families believe that experiencing and having to suffer through chronic pain is a natural part of aging. Luckily, this is not the case. While pain management for the elderly can be a little more nuanced and time-consuming than popping an off-the-counter Combiflam or Tylenol, thankfully there are multiple options that offer relief.
Challenges with Pain Management in Elders
To get chronic pain management right, takes a little time and some creativity. It is an iterative process that requires keen observation before the regimen can be stabilized.
- One of the main reasons is that pain medications work differently on older patients as opposed to younger patients. The primary driver being kidney function, that generally declines with age. As we all know, the kidneys play a prominent role in filtering out drugs – they remove excess waste and extra fluid – while maintaining a healthy balance of water, salts and minerals – such as sodium, calcium, phosphorus, and potassium – in our blood. This must be taken into consideration when determining dosage. A dosage that is too small might not effectively combat the discomfort, and yet a prescription that is too large could cause kidney damage and do more harm.
- The other considerations when determining how to treat an elderly person’s pain include how the medicine will be administered, and what other medications the person may take. In our experience, some elders have difficulty swallowing, so eating pills can be a challenge or a choking hazard. There are possibilities that the prescribed pain management medications could also interact or react with other drugs that the patient is taking for other chronic issues.
All of these factors need to be discussed in detail with your doctor(s), but it should not prevent you from seeking help to manage the pain. It may not always be possible to become pain-free as we age, but doctors can help with pain relief. So don’t be afraid to seek out answers and improve your quality of life.
Things to remember when trying to manage your chronic pain or in elder adults
- The first thing to know is that there are more options than just pills and opioids. While we accept that the regimen may not be as simple or straightforward as it would be for a younger patient, managing pain is still possible. Topical analgesics are one option which offer pain relief and typically means you don’t have to worry about one more pill or mixing medications.
- When visiting the doctor or the healthcare professional of your choice, be honest about how you are feeling. Ideally keep a small diary or list of what the symptoms have been, how long you have experienced them, any factors that cause the situation to escalate etc. Allow them to assess the situation and most important of all do not try and self-diagnose.
- It is possible that light exercises like yoga, taichi or a consistent stretching routine may help you find relief. In addition, helping build back lost muscle mass is usually recommended.
- The doctor may recommend physical therapy, which can be done both in an outpatient facility, or even in the safety of your home.
In conclusion, as we age there will be some aches and pains. However, there are multiple options available today which can help add quality and comfort to our daily existence and even elderly adults can enjoy an active lifestyle.
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