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.

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.

Contributors	p. ix
The anatomy and physiology of pain	p. 1
Pain and sensation	p. 2
Neural pain pathways	p. 5
The pain gate	p. 11
Chronic pain	p. 13
Central sensitization and A[beta] fibre mediated pain	p. 16
Older people	p. 21
Conclusion	p. 23
Relating socio-economic issues to older people and pain: independence, dignity and choice	p. 27
Introduction	p. 27
Economics, health, age and independence	p. 28
Dignity	p. 38
Choice	p. 40
Conclusion	p. 42
'Creaking joints, a bit of arthritis, and aches and pains': older people's experiences and perceptions of pain	p. 49
The study	p. 50
Is pain different for older people?	p. 50
Equating older age with aches and pains	p. 51
Salience of older age linked to whether people experienced pain	p. 52
Effect of pain on everyday lives	p. 53
Managing the pain	p. 55
Keeping a positive attitude	p. 55
Others in relation to pain	p. 56
Implications for practice	p. 58
Case studies	p. 58
Summary	p. 61
Assessment of pain	p. 65
Introduction	p. 55
The need for pain assessment	p. 66
Behavioural pain assessment tools	p. 74
Assessment of pain in terminal care	p. 79
Conclusion	p. 80
Communication and pain	p. 87
Introduction	p. 87
Research	p. 90
Care workers and mentioning dementia	p. 91
Explaining memory loss	p. 93
Conclusion	p. 96
Summary	p. 96
Acute on chronic pain	p. 101
Introduction	p. 101
What is pain?	p. 102
Assessing acute on chronic pain	p. 103
Opiophobia and other barriers	p. 109
Conclusion	p. 110
Cancer pain in elderly people in palliative care settings	p. 115
Introduction	p. 115
How is cancer pain addressed in palliative care settings?	p. 115
What are the issues for older people?	p. 120
Management of cancer pain in elderly people in palliative care	p. 121
Recommendations for practice	p. 123
Conclusion	p. 125
Summary	p. 125
Care homes and other settings	p. 129
Introduction	p. 129
Problems with chronic pain in older people	p. 131
Comments made by residents when asked to discuss their pain	p. 135
Age-related perceptions of pain	p. 137
Lack of awareness of potential strategies for dealing with pain	p. 138
Cognitive behavioural therapy	p. 140
Care-home settings	p. 141
Conclusion	p. 143
Management of a pain by pharmacological intervention in older adults	p. 149
Principles of pharmacology	p. 149
Summary	p. 159
Normal physiological changes in older adults	p. 159
Conclusion	p. 163
Complementary approaches	p. 165
Introduction	p. 165
Why are CAM therapies so appealing?	p. 166
What complementary therapies are available?	p. 167
CAM and pain	p. 169
CAM and older adults	p. 174
Review of the research	p. 175
Research	p. 179
Conclusion	p. 180
Function and rehabilitation	p. 185
The importance of function	p. 185
The role of physiotherapy in rehabilitation	p. 190
Conclusion	p. 194
Future directions	p. 199
Introduction	p. 199
Clinical aspects	p. 199
Research aspects	p. 201
Educational aspects	p. 203
Professional aspects	p. 204
Report on the European Week Against Pain (EWAP)	p. 204
Index	p. 211
Table of Contents provided by Ingram. All Rights Reserved.

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The Management of Pain in Older People

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