The Management of Pain in Older People

  • ID: 2251083
  • Book
  • 226 Pages
  • John Wiley and Sons Ltd
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Epidemiology of pain in the older person is not a subject that has been widely studied in the past, although it has been suggested that almost half of older people in the community suffer with significant pain. This is a major problem within society and with the aging population it is likely that the incidence of pain in this group will continue to rise. There are currently no UK publications that focus specifically upon the needs of the older person in pain. This book will empower individuals who are working with this group to enable them to deal with pain more effectively.

The Management of Pain in the Older Person will enable the reader to understand the principals underpinning the management of pain, with a particular emphasis upon the care of the older person.  Chapters will focus on:

- Highlighting a number of questions or concerns that are important to the topic area and encourage the reader to reflect upon their own experience/beliefs. Chapters will then challenge or confirm these perspectives, encouraging the reader to consider how the theory may be used to make changes

- Concerns of the older person, which have been identified through empirical work over the past few years and the recent completion of a systemic review of literature
- Understanding of the impact of aging upon pain physiology
- Practical suggestions on how to apply both traditional and complementary approaches to pain management
- Using case scenarios to demonstrate the relationship between theory and practice

  The book is designed to encourage the reader to read further and to think about his or her own practice setting or how they would respond to a particular practice situation.  This book is ideal for nurses and would also be a great text for diploma/graduate and post–graduate students working in a range of care settings.
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Chapter 1: Anatomy & Physiology of Pain.

Pain & Sensation.

Neural Pain Pathways.

A Delta fibres.

Dorsal Roots.

Spinal cord to brain.

Descending tracts & Substantia gelatinosa.

The pain gate.

Chronic pain.

Peripheral sensitisation.

Central Senstization.

Older People.

Chapter 2: Relating socio–economic issues with older people and pain: Independence dignity and choice.

Health Economics.

Cultural issues in older age.

Resources linked with being older and in pain .

Policy in health services, economics and older people.

Diet and health in older age, related to economics.




Chapter 3: Creaking joints, a bit of arthritis, and aches and pains : Older people s experiences and perceptions of pain.

The Study.

Is pain different for older people Equating older age with aches and pains.

Salience of older age linked to whether people experienced pain.

Effect of pain on everyday lives.

Managing the pain Keeping a positive attitude.

Others in relation to pain.

Implications for practice Exercises.

Case studies.

Mr Uddim.

Violet Jones.

Learning points.

Chapter 4: Assessment of Pain.

Visual Analogue Scale.

Numerical Rating Scale.

Verbal Descriptors.

Faces Pain Scale.

Colour Scale.

McGill Pain Questionnaire (MPQ).

Sensory Impairment.

Learning disability.

Cognitive impairment.

Perception of Pain.

Behavioural Pain Assessment Tools.

DS DAT Scale.

Checklist of non–verbal Pain Indicators (CNPI).

ADD Protocol.


The NOPAIN Scale.

Pain Assessment Scale for Dementing Elderly (PADE).



Abbey Scale.

Terminal Care.

Chapter 5 : Communication.


Care workers and mentioning dementia.

Explaining memory loss.

Chapter 6: Acute versus Chronic Pain.

Assessing Acute with Chronic Pain.

Treatment for Acute with Treatment for Chronic.

Opiophobia and Other Barriers.

Chapter 7: Cancer Pain in the elderly in palliative care settings.

How is cancer pain addressed in palliative care settings?

The total pain concept – the patient experience.

Multidimensional assessment.

The family in palliative care.

What are the issues for older people Expectations of pain in later life.


Lack of access to specialist palliative care services.

Compliance with pharmacological treatments.

Age related alterations in drug disposition Management of cancer pain in the elderly in palliative care.

Drugs compliance/concordance.

Other treatments.

Recommendations for practice Assessment and management Roles of MDT.

SPCS intervention.

Chapter 8: Care Settings.

Problems with Chronic Pain in Older people.

Physiological Changes.

Getting used to pain.





Research Ongoing.

Reluctance to report pain/ an acceptance that being in pain is normal and low expectations for help with medical interventions Age related perceptions of pain.

Lack of Awareness of potential strategies for dealing with pain.

Multidisciplinary Management.

Cognitive Behavioural Therapy.

Care Home Settings.

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Patricia Schofield PhD, RGN
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