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    Management of Pain in Older People
    Management of Pain in Older People
    Management of Pain in Older People
    Ebook145 pages1 hour

    Management of Pain in Older People

    By Pat Schofield

    ()

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    About this ebook

    A workbook designed to give you a basic introduction into the issues around pain in older people. It explores the size and nature of the problem along with practical assessment and management approaches and will help you to think about the issues in your own area of practice. it is not designed to make you an expert in pain management, but to increase your awareness of the complexity of the pain experience when working with older adults and to help you to understand the need for a creative and innovative approach to dealing with the person in your care who may be in pain.

    Contents include:
    Epidemiology of pain in the older adult
    Snoezelen or sensory environments
    Physiological and biochemical changes
    Cancer pain management
    The importance of communication
    Non-pharmacological approaches
    Assessment of pain to pain management
    The role of the multidisciplinary team
    Case studies
    Pharmacological management of pain
    Test your knowledge section
    Further reading and resources
    LanguageEnglish
    PublisherM&K Update Ltd
    Release dateJan 1, 2010
    ISBN9781907830228
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      Book preview

      Management of Pain in Older People - Pat Schofield

      -1-905539-19-2

      The Management of Pain in Older People:

      a workbook

      Pat Schofield

      Barry Aveyard

      Catherine Black

      The Management of Pain in Older People

      Pat Schofield, Barry Aveyard and Catherine Black

      ISBN 978-1-905539-22-2

      First published 2007

      All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without either the prior permission of the publishers or a licence permitting restricted copying in the United Kingdom issued by the Copyright Licensing Agency, 90 Tottenham Court Road, London, W1T 4LP.

      Permissions may be sought directly from M&K Publishing, phone: 01768 773030, fax: 01768 781099 or email: publishing@mkupdate.co.uk

      Any person who does any unauthorised act in relation to this publication may be liable to criminal prosecution and civil claims for damages.

      British Library Cataloguing in Publication Data

      A catalogue record for this book is available from the British Library

      Notice

      Clinical practice and medical knowledge constantly evolve. Standard safety precautions must be followed, but, as knowledge is broadened by research, changes in practice, treatment and drug therapy may become necessary or appropriate. Readers must check the most current product information provided by the manufacturer of each drug to be administered and verify the dosages and correct administration, as well as contraindications. It is the responsibility of the practitioner, utilising the experience and knowledge of the patient, to determine dosages and the best treatment for each individual patient. Neither the publisher nor the authors assume any liability for any injury and/or damage to persons or property arising from this publication.

      The Publisher

      To contact M&K Publishing write to:

      M&K Update Ltd · The Old Bakery · St. John’s Street

      Keswick · Cumbria CA12 5AS

      Tel: 01768 773030 · Fax: 01768 781099

      publishing@mkupdate.co.uk

      www.mkupdate.co.uk

      Designed & typeset in 11pt Usherwood Book by Mary Blood

      Printed in England by Reed’s Ltd. Penrith

      Contents

      List of figures and tables

      About the authors

      Introduction

      1. Epidemiology of pain in the older adult

      Pat Schofield

      2. Physiological and biochemical changes

      Pat Schofield

      3. The importance of communication

      Barry Aveyard

      4. Assessment of pain

      Barry Aveyard and Pat Schofield

      5. The role of the multidisciplinary team

      Pat Schofield

      6. Pharmacological management of pain

      Pat Schofield

      7. Snoezelen or sensory environments

      Pat Schofield

      8. Cancer pain management in the older person

      Catherine Black

      9. Non-pharmacological approaches to pain management in the older person

      Catherine Black

      Appendix 1: Case studies

      Appendix 2: Test your knowledge

      Quiz

      Key word definitions

      Word search

      Appendix 3: Further reading and resources

      Tables

      4.1 Assessement of pain

      6.1 Combination analgesics on NHS prescription

      6.2 Opioid drugs

      Figures

      2.1 Factors influencing the pain threshold

      4.1 Visual analogue pain scale

      4.2 Numerical rating pain scale

      4.3 Verbal pain descriptors

      4.4 Faces pain scale

      6.1 The three step analgesic ladder

      8.1 The components of total pain

      ABOUT THE AUTHORS

      Pat Schofield RGN, PhD, PGDipEd, DipN

      Pat has worked in the field of pain management since 1988. Initially as a specialist nurse and later as a lecturer and senior lecturer. She has been a member of the Council of the British Pain Society and is currently chair of their newly-formed Special Interest Group on Older People. Pat’s research interests concern older people and she has carried out a number of research projects talking to residents living in care homes along with a systematic review of the literature on pain management in older adults and two annotated bibliographies on pain at the end of life and older adults. Pat has facilitated the pain management course for nurses for the past 19 years and has been responsible for developing part of the course as a distance learning programme.

      Catherine Black MAEd, BA (Hons) Nursing, RN, RNT,

      Dip Health Services Manager

      Catherine is a Senior Lecturer at the DHSS Education and Training Centre in the Isle of Man. Prior to this she was the Senior Sister at the St Bridget’s Hospice in the Isle of Man. Catherine qualified as a nurse in 1990 and specialised in oncology, clinical trials and, more recently, palliative care. She worked at Weston Park Hospital in Sheffield and the University of Sheffield before returning to the Isle of Man in 2000. Her current interests include pain management, palliative care and research methodologies.

      Barry Aveyard RMN, RGN, BA (Hons), CertEd, RNT, MA

      Barry is qualified in both adult and mental health nursing. His experience covers a wide range of clinical settings; however working with older people is his key area of interest. He has worked in nurse education for several years as a teacher and lecturer and is also a member of the Royal College of Nursing Mental Health and Older People’s Forum. He has published chapters and papers on various aspects of mental health in older people.

      Introduction

      This workbook is designed to give you a basic introduction to the management of pain in older people. It explores the size and nature of the problem, outlines some practical assessment and management approaches, and, finally, aims to help you think about the particular issues in your own area of practice.

      The book is not designed to make you an expert in pain management but to increase your awareness of the complexity of the pain experience when you are working with older adults and to help you to understand the need for a creative and innovative approach to dealing with the person in your care who may be in pain.

      Opportunities for further study in a particular area are also included as Further reading sections at the end of individual chapters. For more resources on the management of pain in older people in general see "Appendix 3: Further reading and resources" at the end of the book.

      1 Epidemiology of pain in the older adult

      Pat Schofield

      In Pain and Suffering in the Elderly, Harkins et al. (1990) begin with four important questions.

      What is the age-related epidemiology of pain problems?

      Is age a predisposing factor for chronic pain?

      Does the perception of pain decrease with age?

      Does age affect the diagnosis and treatment of pain in the clinical setting?

      This workbook is intended to enable you to explore and answer these questions, while relating them to your own clinical practice.

      AN AGEING POPULATION

      ‘I’m tired – not just tired, but tired of being in pain.’

      The epidemiology of pain in the older adult has not been widely studied until recently. The International Association for the Study of Pain (IASP) has recently published some epidemiological information on their website for the Global Year against Pain in Older Adults (which is 2006–7). Some of this information will be discussed within this chapter. (For more information about this event see www.efic.org/week.html.)

      The population is ageing worldwide and it is expected that there will be a rise in the over 65 age group by 17 per cent by 2050, meaning that over 65s will make up more than 36 per cent of the total population. The

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