Assessment and management of pain in older adults: A review of the basics

Pain in patients older than 65 years of age is significantly undertreated and misunderstood. This may be based on the assumption that older patients either cannot tolerate stronger pain medications or do not experience pain in the same way as younger patients. However, many older patients have chronic conditions, such as arthritis or diabetic neuropathy, in which pain is a daily occurrence and affects quality of life. One of the biggest barriers to pain management in older patients is how to assess pain effectively. Most older patients can use a 0-10 pain scale, but other patients who are cognitively impaired are more complex to assess and require different types of pain assessment tools and techniques. More importantly, once the assessment is complete, trying to decide which pain medication is best for an older patient with organ impairment or complications of the aging process presents another set of issues. The discussion in the following article focuses on pain assessment and pain management options for the older patient.