title: Advances in pain management for older adult patients.
abstract: Management of pain is crucial to the success of any program of care and support for dying patients and their families. Pain can be controlled in more than 90% of older adults. Components of an effective program include comprehensive, repeated pain assessment; detection and treatment of complicating medical and psychological disorders (e.g., delirium); spiritual concerns; and the judicious use of nonpharmacologic and pharmacologic therapies, radiation, and radiopharmaceuticals. Strategies that enable clinicians to prevent and treat the expected complications of nonsteroidal anti-inflammatory and opioid therapies are reviewed. Strategies to change opioid agents or routes to minimize opioid-induced side effects and to provide effective pain relief as death nears are presented.
authors.affiliation: Division of Hematology/Oncology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
authors.forename: J L
authors.initials: JL
authors.lastname: Abrahm
mesh_terms: D000368:Aged; D000465:Algorithms; D000700:Analgesics / Q000009:adverse effects / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use; D003663:Decision Trees; D003693:Delirium / Q000150:complications; D003704:Dementia / Q000150:complications / Q000175:diagnosis; D004334:Drug Administration Schedule; D005190:Family / Q000523:psychology; D015577:Geriatric Assessment; D006801:Humans; D010146:Pain / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D010147:Pain Measurement / Q000379:methods; D010327:Pastoral Care / Q000379:methods; D013727:Terminal Care / Q000379:methods* / Q000523:psychology
chemical_list: D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal