Pain

Pain in the Elderly: When Someone You Love Is in Pain

Improve chances for obtaining good pain relief:

• Use pain medicines as prescribed. If the prescription says to take the pain medicine at certain times or at certain time intervals, do so. Do not wait until the pain comes back to give the medicine. This will cause needless suffering. There has to be a certain amount of medicine in the blood before it can reduce pain. This is why the doctor prescribes taking the medicine at regular intervals—to be sure that the blood levels stay high enough.
• Insist on good pain control. Pain tends to be undertreated. Make sure the doctor knows there is a pain problem, and let him or her know if treatment is not working or not meeting the older person's needs.
• Ask about pain clinics. If your doctor cannot control the pain, ask for a referral to a pain clinic. Universities and large hospitals often have clinics to evaluate and treat pain.

When symptoms are not an emergency but should be reported: The following symptoms should be reported during regular office hours. Call the doctor if any of the following conditions exist:

• No relief after taking pain medicine as prescribed
• Some pain relief, but there is still a lot of pain 1 or 2 days after starting the medicine
• A new type of pain, pain in new locations or new pain when moving or sitting
• Adverse side effects of pain medicines

In case of an emergency, seek medical help immediately if any of the following occur:

• Change in the ability to walk or carry out other important activities because of pain
• Changes in sleep
• Inability to cope with pain

If calling about an emergency, know these facts before you call:

• How long has the pain been a problem?
• Is it a new pain or has it happened before?
• Where is it located? Is it in more than one area? If so, which location is most bothersome?
• How severe is the pain? Ask the older person to rate the pain on a scale of 0 to 10, where 0 = no pain, 5 = moderate pain, 10 = worst ever
• Is the pain sharp and stabbing or dull and aching?
• What does the pain feel like? For example, does the pain burn or feel like an electric shock?
• Is there any numbness or tingling?
• How does the pain interfere with doing normal activities? What activities or conditions make the pain worse?
• What has been done to relieve the pain?
• What medicines are being taken? Are the medicines taken at set times or just when the person needs them? Is he or she allergic to or sensitive to any pain medicine?

Help to reduce pain:

• Use warm showers, baths, hot water bottles, or warm washcloths. Heat relaxes muscles, which can help reduce pain, and gives a sense of comfort. Do not set heating pads on high because they can burn the skin.
• Use cool cloths or ice. Cooling the skin and muscles can soothe pain, especially pain that comes from inflammation or swelling.
• Position the person carefully with pillows and soft seat cushions.
• Encourage relaxation. Breathing slowly and quietly helps the mind and body to relax and helps decrease pain. Simple relaxation methods can be learned from books or audiotapes on relaxation techniques.
• Provide pleasant activities
• Avoid stressful events when possible.

Checking on results:

Ask about pain regularly and keep notes. Adjusting pain medicines to fit each patient takes time, so change may be slow. Keep the doctor or nurse informed about changes in pain.

Source: The American Geriatrics Society Foundation for Health in Aging. Eldercare at Home, Chapter 11-Pain.

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