The Management of Pain in Older People

This book will enable readers to understand the principles underpinning the management of pain which a particular emphasis upon the care of the older adult. The chapters will explore concepts that are recognised to be involved in the pain experience but each author will then add their own unique perspective by applying the principles to their specialist area of practice and the care of the older adult. It is structured to include the aims and outcomes of the chapter at the beginning so that readers can track their progress, and provides chapter outlines and further reading suggestions foir this unique topic area.

Autorentext

Dr Pat Schofield PhD PGDipEd DipN RGN, Senior Lecturer

• University of Sheffield, School of Nursing &
  Midwifery.

Pat Scofield one of the leading International nurse academics
working in the field of pain management and in the field of
multisensory environments (Snoezelen). She has a consistent record
of publication of articles of national and international status and
is invited to present her work at national and international
nursing and multidisciplinary conferences, including the World Pain
congress. She has presented in three continents during the last 2
years.

Klappentext
Epidemiology of pain in the older person is not a subject that has been widely studied in the past, although it has been suggested that almost half of older people in the community suffer with significant pain. This is a major problem within society and with the aging population it is likely that the incidence of pain in this group will continue to rise. There are currently no UK publications that focus specifically upon the needs of the older person in pain. This book will empower individuals who are working with this group to enable them to deal with pain more effectively. The Management of Pain in the Older Person will enable the reader to understand the principals underpinning the management of pain, with a particular emphasis upon the care of the older person. Chapters will focus on:

• Highlighting a number of questions or concerns that are important to the topic area and encourage the reader to reflect upon their own experience/beliefs. Chapters will then challenge or confirm these perspectives, encouraging the reader to consider how the theory may be used to make changes

• Concerns of the older person, which have been identified through empirical work over the past few years and the recent completion of a systemic review of literature
• Understanding of the impact of aging upon pain physiology
• Practical suggestions on how to apply both traditional and complementary approaches to pain management
• Using case scenarios to demonstrate the relationship between theory and practice
  The book is designed to encourage the reader to read further and to think about his or her own practice setting or how they would respond to a particular practice situation. This book is ideal for nurses and would also be a great text for diploma/graduate and post-graduate students working in a range of care settings.

Inhalt

Chapter 1: Anatomy & Physiology of Pain.

Pain & Sensation.

Neural Pain Pathways.

A Delta fibres.

Dorsal Roots.

Spinal cord to brain.

Descending tracts & Substantia gelatinosa.

The pain gate.

Chronic pain.

Peripheral sensitisation.

Central Senstization.

Older People.

Chapter 2: Relating socio-economic issues with older peopleand pain: Independence dignity and choice.

Health Economics.

Cultural issues in older age.

Resources linked with being older and in pain .

Policy in health services, economics and older people.

Diet and health in older age, related to economics.

Independence.

Dignity.

Choice.

Chapter 3: Creaking joints, a bit of arthritis, and aches andpains': Older people's experiences and perceptions ofpain.

The Study.

Is pain different for older people Equating older age with achesand pains.

Salience of older age linked to whether people experiencedpain.

Effect of pain on everyday lives.

Managing the pain Keeping a positive attitude.

Others in relation to pain.

Implications for practice Exercises.

Case studies.

Mr Uddim.

Violet Jones.

Learning points.

Chapter 4: Assessment of Pain.

Visual Analogue Scale.

Numerical Rating Scale.

Verbal Descriptors.

Faces Pain Scale.

Colour Scale.

McGill Pain Questionnaire (MPQ).

Sensory Impairment.

Learning disability.

Cognitive impairment.

Perception of Pain.

Behavioural Pain Assessment Tools.

DS DAT Scale.

Checklist of non-verbal Pain Indicators (CNPI).

ADD Protocol.

DOLOPLUS Scale.

The NOPAIN Scale.

Pain Assessment Scale for Dementing Elderly (PADE).

PAINAD.

PACSLAC.

Abbey Scale.

Terminal Care.

Chapter 5 : Communication.

Research.

Care workers and mentioning dementia.

Explaining memory loss.

Chapter 6: Acute versus Chronic Pain.

Assessing Acute with Chronic Pain.

Treatment for Acute with Treatment for Chronic.

Opiophobia and Other Barriers.

Chapter 7: Cancer Pain in the elderly in palliative caresettings.

How is cancer pain addressed in palliative care settings?

The total pain concept - the patient experience.

Multidimensional assessment.

The family in palliative care.

What are the issues for older people Expectations of pain inlater life.

Co-morbidity.

Lack of access to specialist palliative care services.

Compliance with pharmacological treatments.

Age related alterations in drug disposition Management of cancerpain in the elderly in palliative care.

Drugs compliance/concordance.

Other treatments.

Recommendations for practice Assessment and management Roles ofMDT.

SPCS intervention.

Chapter 8: Care Settings.

Problems with Chronic Pain in Older people.

Physiological Changes.

Getting used to pain.

Assessment.

Management.

Education.

Assets.

Research Ongoing.

Reluctance to report pain/ an acceptance that being in pain isnormal and low expectations for help with medical interventions Agerelated perceptions of pain.

Lack of Awareness of potential strategies for dealing withpain.

Multidisciplinary Management.

Cognitive Behavioural Therapy.

Care Home Settings.