Pain and the management of pain has become a pervasive issue in our nation. So significant has the management of pain become that in 2011, the federal government convened an Institute of Medicine Committee on Advancing Pain Research, Care and Education, which reported its findings in a 350-page publication. The committee determined that pain is a national issue, that government health agencies and other providers need to do better at identifying and managing pain, and that the subject of pain deserves wider public attention.
Yet pain medication, which can be highly addictive, is also highly regulated, and doctors are scrutinized closely for over-medicating patients, even losing their licenses when knowingly, or in some cases unknowingly, providing pain medication prescriptions to those who don’t really need it. The current culture of treating pain with medication has become one of high suspicion. The scrutiny patients endure when requesting pain medication, and the confusion sufferers as to how much pain warrants medication, has been exacerbated by the media spin on the subject of prescription drug abuse. This scrutiny is thought to lead to a lesser reporting of pain from those who may be truly suffering.
Different people tolerate different levels of pain and find different things painful. Studies show that different cultures also differ in tolerance to pain. Menstruating women react to pain differently at different times in their cycle. There are also age variants to levels of tolerable pain. All of these factors are further complicated by the fact that each cultural group, age group, and sex reports pain in different ways.
For the senior care providers, pain and aging has multiple dimensions. Pain may be caused by disease, aging, lack of exercise, or mental condition. The ability to communicate levels of pain may be impeded by physical or cognitive abilities, ones life-long pattern of dealing with pain, or ones comfort in talking about pain. For some elders, pain may be considered a weakness or sign of aging that they just can’t admit to.
It takes a sensitive and trained team of care providers to assess an elder’s pain and devise a pain management plan that will treat the elder without impeding their ability to enjoy their life and activities.
While medication plays an important part in managing elder pain, there are many other treatments utilized to reduce or eliminate pain that are not medicinal. Physical exercise is an important remedy for minor aches and pains, and is a mood enhancer as well. Yoga, walking, dance, exercise class, and physical therapy programs are provided at Green Hill weekly, and elders are encouraged to participate at a level that is helpful to them.
Music therapy, massage, acupuncture and other activities may help elders manage pain brought on by age or injury. And studies show that laughter and fun takes the hurt out of pain, albeit temporarily.
Medication is an important tool to rectify serious levels of pain management, and if properly prescribed can be a very effective balm to discomfort. At Green Hill, nurses assess each patient using a Pain Assessment Protocol within 24 hours of admission, or upon injury, or complaint of pain. Elders are monitored daily, assessed weekly, or if in residence an elder has on onset of restlessness, change in behavior, or refusal of care, or at the day of planned discharge.
All assessments and reports are documented and tracked using a Pain Scale Tracking Form. Physicians are contacted regarding pain management and an inter-disciplinary care plan is initiated for the elder. Patients are reassessed weekly, or as needed, and families are notified if an elder has a change in condition.
At Green Hill, pain management protocols are reassessed quarterly to ensure that all of the latest techniques are utilized in the care of our elders, and that all staff are aware of, and enacting correct procedures. Policies and procedures analyses include behaviors that potentially indicate pain, personal traits, and cultural traits, spiritual and ethnic beliefs that may impact an elder’s perception of pain.
Recognizing, assessing and treating an elder’s pain is an important part of ensuring a happy, healthy and comfortable life. Whether you are a family member, caregiver or care provider, learn to recognize when your elder is in pain. Speak candidly with them and speak with your health care provider about medical and other remedies to overcome pain in your elder.