Advances in pain management for older adult patients.
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.
Abrahm
J L
JL
Division of Hematology/Oncology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
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
D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal