[Problems recognizing pain in geriatrics].
OBJECTIVE
Elderly people often present substantial problems in pain assessment. The aim of the study was to quantify and discuss the problem of recognizing pain in hospitalized geriatric patients.


METHODS
124 geriatric patients and their treating doctors were questioned about pain, pain intensity and influence of pain on daily living in a cross-sectional-study. The score of the Barthel index (activity of daily living, ADL) at admittance and discharge, the cognitive status (monumental status of Folstein, MMS), the use of analgetic drugs and the medical diagnoses were assessed. The answers of the question "Did you/your patient have pain in the past seven days?" from patients and doctors were used to make seven groups.


RESULTS
20 (16,1%) patients could not answer the question about pain. In comparison to the group of patients who were able to answer, they were restricted in ADL and MMS. However, the answers of doctors about pain did not differ. 25 (20,3%) answers of treating doctors were wrong compared to the answers of the patients. In these cases, intensity and influence of pain on daily living were estimated low by the patients. In 14 (11,3%) patients, doctors could not state about pain. These patients were least restricted in ADL at admission and discharge. Altogether, the pain of 13/46 (28,3%) patients was treated insufficiently at the day of the interview.


CONCLUSIONS
In half of the geriatric patients, pain was not well or not at all recognized by the treating doctors. Pain of not communicative patients was assessed similarly by the doctor as that of patients who were able to give information. In this geriatric hospital, little support at admittance and a superior improvement in the activities of daily living during the in-hospital treatment lead to less attention to pain by the doctor. The importance of pain therapy in geriatrics is illustrated by the fact that almost every third patient with pain is treated insufficiently at the day of the interview.
Schuler
M
M
Geriatrisches Zentrum Bethanien am Klinikum der Universität Heidelberg, Germany. SchulerBethanien@web.de
Hestermann
M
M
Hauer
K
K
Schlierf
G
G
Oster
P
P
D000203:Activities of Daily Living; D000368:Aged; D001463:Barbiturates / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010146:Pain / Q000188:drug therapy / Q000503:physiopathology*; D010820:Physicians
D001463:Barbiturates