Living with persistent pain: experiences of older people receiving home care.
BACKGROUND
Although the topic of pain among older people has received increasing interest, little is still known about how pain is experienced or handled by those who no longer manage independently but depend on professionals for help with daily living. Developing pain management for older people requires such knowledge.


OBJECTIVE
To explore sense of self, sense of pain, daily living with pain, sense of others and ways of handling pain in older people with persistent pain.


METHODS
Interviews with 90 older people receiving home care from nursing auxiliaries in their own homes or in sheltered accommodation were collected from January to June 2000. A typology of older people in persistent pain was developed. Activities for handling pain were examined using content analysis.


RESULTS
Respondents' experiences of themselves and their pain varied. Two groups of older people, considered as 'competent and proud' and 'confident and serene', expressed satisfaction in spite of pain, while the groups 'misunderstood and disappointed' and 'resigned and sad' expressed dissatisfaction. The most common strategies used were medication, rest, mobility, distracting activities and talking about pain. Respondents chose strategies by balancing the advantages of the activities against the disadvantages these brought for their daily living.


CONCLUSIONS
This study indicates that characteristics of the older people, such as their way of experiencing themselves, how pain affects their daily life and how they perceive effects and side-effects of pain management are areas that need to be identified when staff assess pain and plan pain management. Caring for older people in pain could be improved by listening to and believing their complaints, evaluating effects and side-effects from medications and nonpharmacological pain management and by emphasising the importance of common everyday activities such as mobility and distraction to relieve pain.
Blomqvist
Kerstin
K
Department of Nursing, Lund University, Lund, Sweden. kerstin.blomqvist@omv.lu.se
Edberg
Anna-Karin
AK
D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000368:Aged / Q000523:psychology*; D001294:Attitude to Health; D003152:Community Health Nursing; D005260:Female; D016330:Frail Elderly / Q000523:psychology*; D015577:Geriatric Assessment; D006699:Home Care Services; D016852:Housing for the Elderly; D006801:Humans; D008297:Male; D020380:Needs Assessment; D015404:Nursing Methodology Research; D010146:Pain / Q000517:prevention & control* / Q000523:psychology*; D012064:Relaxation Therapy; D012648:Self Care / Q000379:methods; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D013548:Sweden