title: CE: Assessing and Managing Pain, Agitation, and Delirium in Hospitalized Older Adults.
abstract: : In the acute care setting, pain, agitation, and delirium (PAD) often occur as interrelated parts of a syndrome rather than as separate entities. Because the three facets of PAD may be similar in presentation, it is often difficult for clinicians to recognize the syndrome and to assess and treat it. The challenge is particularly great in older patients, who are more likely than their younger counterparts to have such comorbid conditions as dementia, which may impair the ability to report pain, or age-related physiologic changes that may affect the metabolism and clearance of certain medications. This article provides an overview of each aspect of PAD, discusses clinical considerations related to the assessment and treatment of the syndrome in older adults receiving acute care, and illustrates the application of published PAD guidelines through the use of a hypothetical patient scenario.
authors.affiliation: Tonja M. Hartjes is an acute care NP and a clinical associate professor at the University of Florida College of Nursing, Gainesville, where Ann L. Horgas is an associate professor. Lauren Meece is a certified NP and left ventricular assist device coordinator at University Hospitals in Cleveland, OH. Contact author: Tonja M. Hartjes, tonjahartjes@gmail.com. The authors and planners have disclosed no potential conflicts of interest, financial or otherwise.
authors.forename: Tonja M
authors.initials: TM
authors.lastname: Hartjes
authors.forename: Lauren
authors.initials: L
authors.lastname: Meece
authors.forename: Ann L
authors.initials: AL
authors.lastname: Horgas
mesh_terms: D000368:Aged; D003693:Delirium / Q000175:diagnosis / Q000451:nursing* / Q000628:therapy; D004496:Education, Continuing; D006760:Hospitalization; D006801:Humans; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement / Q000379:methods*; D011595:Psychomotor Agitation / Q000175:diagnosis / Q000451:nursing* / Q000628:therapy