Keeping Pain Under Control

Pain at any age is a disruptive part of life and, as a member ages, is most likely to increase. Pain Assessment and Management is an important part of care for the elderly. In the older patient, the incidence and prevalence of certain pain syndromes may increase. While not all pain can be eliminated, most pain can be managed. Pain may be underreported and undertreated by your elderly patients because they believe that pain is a normal process of aging. Because your elderly patients may not volunteer information about living with chronic pain, it is important that you assess their pain at least annually.

Undertreating pain can severely affect your patient’s health and quality of life, and can lead to adverse physical and psychological outcomes for them and their families. The effects of chronic pain show up as depression or anxiety, and may create a sense of helplessness and even hopelessness.

Be sure to document medical records carefully and include the date of your pain assessment exam. Notations for a pain assessment should include one of the following:

  • Documentation that the patient was assessed for pain (which may include positive or negative findings for pain).
  • Result of assessment using a standardized pain assessment tool, not limited to:
    • Numeric rating scales (verbal or written)
    • Verbal descriptor scales (5–7 Word Scales, Present Pain Inventory)
    • Pain Thermometer
    • Pictorial Pain Scales (Faces Pain Scale, Wong-Baker Pain Scale)
    • Visual analogue scale
    • Brief Pain Inventory
    • Chronic Pain Grade
    • Patient Reported Outcomes Measurement Information System (PROMIS) Pain Intensity Scale
    • Pain Assessment in Advanced Dementia (PAINAD) Scale
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