Pain In The Elderly

Running Head: PROPERLY ASSESSING PAIN

Properly Assessing Pain in the Elderly

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Summary

This summary on properly assessing pain in the elderly is adapted from the article written for professionals by pain assessment experts. Under assessment of pain in the elderly is a significant problem that is common among health care professionals. Although pain is a universally experienced phenomenon, reactions to pain vary widely among the elderly. Some elderly patients may not even report problems with pain. Pain is defined as a subjective experience, therefore nurses should not only rely on common signs and symptoms of pain, one has to rely on the individual's own perception as well as verbal and nonverbal expressions in assessing and evaluating the pain experience.

Nurses should be aware that pain may be expressed by observing signs of guarding, moaning, facial grimacing, agitation, rigidity, hypersensitivity to touch, the patient reporting a change in appetite or mental status, depression and possibly the patient showing signs of withdrawing (Victor, 2001 p. 46). Successful pain assessment will require an analysis of the causes, a framework for understanding the pain, and a simple yet comprehensive protocol to assist health care professionals in assessing, documenting, and treating pain in the elderly. This framework should provide a good indicator for nurses to assess signs and symptoms of pain. There may be several reasons for under-assessment of pain in the elderly, including patient beliefs and communication problems. The nurse should use effective communication skills by exploring ways to get the patient to freely express their experiences of pain and discomfort.

The elderly are especially susceptible to under-assessment of pain because of their beliefs about aging and misconceptions about pain. If the elderly believe that pain is a natural part of the aging process, then they are less likely to report being in pain. Additional problems related to under-assessment of pain in the elderly concern other commonly held beliefs. Patients may view the admission of pain as a weakness; fear that the pain signals disease progression; fear taking medications because of possible side effects; or fear that they are not being a "good patient" and that reporting pain is a bother to nurses. When this belief is communicated to health care providers, providers are unlikely to treat the pain. Nurses' should be aware of this and have the knowledge to inform patients about pain management. The nurse should help the patient identify pain. It may be necessary for the nurse to monitor the pain until the patient expresses a level of acceptance. The nurse should document feelings of pain and discomfort that affect activities of daily living.

Communication problems associated with sensory and cognitive impairment also are causes of undertreatment related to the underreporting of pain in the elderly. This is a reason there are many different ways to report pain. Pain may be described using a Numeric Rating Scale, where 1 is the least amount of pain experienced and 10 would be the most severe pain experienced. Another tool may be the Wong-Baker FACES Scale, where different faces are used to illustrate to the healthcare provider what the pain feels like. Nurses also may have limited ability to detect pain in nonverbal and cognitively compromised elderly patients, therefore these scales can provide an effective component to assess pain and provide adequate relief.

Strengths of the Article

In reading the article, I think there were a lot of key points that were addressed. The article went into nurses' duties and obligations when assessing pain in the elderly. Inadequate education in pain management for health care professionals is a major problem leading to undertreatment. Since a lot of health care professionals are seldom trained in pain assessment,