Pain management refers to reducing or relieving pain, or regulating it with the use of medications, procedures, emotional support, exercises and therapy. When we refer to pain, we mean an unpleasant sensory and emotional expression associated with actual or potential tissue damage.

Statistically, lower back pain is the most common type of pain suffered by elderly people in the UAE.

There is a significant prevalence of back pain in the UAE at 60%, the majority of lower back pain cases are the result of an injury, such as muscle sprains or strains due to sudden movements or poor body mechanics while lifting heavy objects and lack of regular outdoor exercise, as well as bone degeneration in the elderly. Chronic joint pain is experienced by 15% to 25% of people, and musculoskeletal pain 40%.

Care strategies for improving pain management in elderly patients can include:

Assessing Pain Levels:

Regular assessment of pain levels is crucial for tailoring appropriate interventions. Pain scales such as numeric, facial and FLACC can be utilised.

Individual Pain Plans:

Each elderly pain experience is unique, requiring personalised pain management plans. The following factors must be  considered when developing an individualised plan:

  • The type and location of pain
  • The underlying cause of pain
  • Any triggers to the pain – ie movement, coughing etc
  • Medical history and any contraindications
  • The individual’s preferences and goals

Medication, Management & Collaboration:

Appropriate medication management is a fundamental aspect of pain management in elderly patients.

Collaborate closely with healthcare professionals, including physicians and pharmacists, to develop a comprehensive medication plan. Regularly review the effectiveness of medications and adjust the regimen if needed.

Be aware of potential side effects and adverse drug interactions. Educate elderly patients and their family members about medication usage and potential risks. Ensure safe and effective pain management by maintaining open communication and collaboration with healthcare professionals, elderly patients and their families.

Non-Pharmacological Approaches:

Can significantly enhance pain management in elderly patients. The following techniques below put into practice would greatly improve pain management in elderly patients:

Physical therapy and exercise: Engage elderly individuals in physical activities and exercise to improve mobility, strengthen muscles, and alleviate pain. Such exercises include passive range of motion, active assistive range of motion, active range of motion, progressive resistive exercise, balance training, gait training, postural correction and reeducation, and ergonomics.

Mobilisation and manipulation of the  joints

Heat and cold therapy: Apply heat or cold packs to relieve temporary pain.

Massage and relaxation techniques: Explore the benefits of therapeutic massage, deep breathing exercises, or to promote relaxation and alleviate pain.

Psycho-Education Intervention Using    Cognitive Behavioural Therapy:

  • Assess the patient, especially those with cognitive impairment, for unmet needs which could be interpreted as pain such as hunger, loneliness, depression, need to be toileted, to speak to a loved one, sleeplessness, anxiety and meet the need.
  • Assure the patient is comfortable; reposition, if appropriate to the patient’s level of function engage in an activity such as walking.

Environmental Modification:

Creating a comfortable and supportive environment is vital in pain management for elderly parents. Consider the following environmental modifications:

  • Ensure proper lighting to minimise eye strain and create a visually comfortable space.
  • Optimise temperature control to maintain a cosy and soothing atmosphere.
  • Arrange furniture ergonomically to promote good posture and reduce discomfort.
  • Use supportive bedding and cushions to alleviate pressure points and provide adequate support.

Emotional Support & Mental Wellbeing:

Note that pain management extends beyond the physical aspect.  Emotional support and mental wellbeing are integral to comprehensive care. Consider the following strategies:

  • Encourage social engagement and interaction with friends, family, and support groups to alleviate feelings of isolation.
  • Promote cognitive stimulation through activities such as puzzles, reading, or learning new skills to maintain mental sharpness and distract from pain.
  • Provide emotional coping strategies such as mindfulness techniques such  as journaling, or talking therapies to address pain-related emotional distress.
  • Provide elderly patients with distractive techniques such as watching TV, moving around the home or taking the patient to the garden to distract them from the pain.
  • Hope we have helped you to understand pain management in the elderly, and how to maintain a healthy life free of pain.
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