The Aging Adult
No evidence exists to suggest that older individuals perceive pain to a lesser degree or that sensitivity is diminished. Although pain is a common experience among individuals 65 years of age and older, it is not a normal process of aging. Pain indicates pathology or injury. Pain should never be considered something to tolerate or accept in one's later years.
Unfortunately, many clinicians and older adults wrongfully assume that pain should be expected in aging, which leads to less aggressive treatment. Older adults have additional fears about becoming dependent, undergoing invasive procedures, taking pain medications, and having a financial burden. The most common ...view middle of the document...
19 A pain gene exists, which helps explain why some people feel more/less pain even with the same stimulus. Efforts are being made to tailor pharmacologic agents to improve pain treatment based on genetic sequencing.
Culture and genetics
Please review the cultural variations in Chapter 2. As clinicians, adopt the habit of asking each patient how he or she typically behaves when in pain.
Most of the research conducted on racial differences and pain has focused on the disparity in management of pain for various racial groups—comparing pain treatment for individuals of color (e.g., Blacks, Hispanics) with the standard treatment for all individuals with similar injuries or diseases. Various studies describe how Black and Hispanic patients are often prescribed and administered less analgesic therapy than whites, although the majority of these differences is quite small.16
Pain is defined as an “unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage. Pain is always subjective.”2
The subjective report is the most reliable indicator of pain. Because pain occurs on a neurochemical level, the diagnosis of pain cannot be made exclusively on physical examination findings, although these findings can lend support.
INITIAL PAIN ASSESSMENT
Do you have pain? Discomfort or soreness? Ouch?
Some people will report pain only when it is severe. Try a variety of words.
Where is your pain? Tell me about all of the places that have pain.
Pain may be localized or occurring in multiple sites.
3. When did your pain start?