Pain Management in the Elderly Population

Question: Discuss about the Pain Management in the Elderly Population? Answer: Several studies have been carried out to study differences in pain perception due to differences in ethnicity and gender. Ethnic groups share a common ancestry and cultural beliefs and have a group identity. In a review that has analysed studies on pain and its dependence on ethnic difference pain intensity experienced by people of Italian descent has been found to be greater than people from other ethnic groups. The measurement of pain was based on the McGill Pain Questionnaire's total pain rating index. (Edwards, 2012). Another study that evaluated back pain among older patients found that pain reported by Italian men was more severe than that reported by Australian men in Australia. The occupation and level of education received by the subjects also played a role in the perception of pain. (Stanaway FF1, 2011). These two instances support the higher rate of complaints related to pain by the Italian patient referred in the given case study. Another study has studied the extent of relief experienced by patients of different ethnicities on receiving treatment for pain. Due to higher levels of pain experienced by an ethnic group the effect of analgesics and the relief from pain were higher than the majority group in this study (Brian Merry, 2011). That gender plays an important role in experiencing pain has become evident in recent decades. Women are more likely to have a higher sensitivity for pain than men. The chances for clinical pain experienced by women is also higher than in men. The biological mechanisms of how pain is experienced seem to play a role and so do psychosocial factors. Sex hormones, genes and psychology considerably affect the mechanism of pain (Fillingim, 2013). Given this background it is highly likely for women such as Mrs. G. to feel pain more than her male counterparts facing a similar medical condition(Mogil, 2012). Her ethnicity and the fact that she belongs to a minority ethnic group may also contribute to a pain perception that is greater than that experienced by people native to the country. Age also plays a role in increased perception of pain. Being old and dependent can cause the patient to feel more pain due to a sense of helplessness. Nursing professionals are more likely to assess pain and take decisions about the need for medication based on the knowledge of ethnicity and gender of the patients. This may induce a bias in the decision regarding medication (Wandner LD1, 2014)(Phelan SM1, 2015). e. Since Mrs G is distressed and in pain. Her perception of pain could be greater because she feels helpless and owing to her advanced age may be lonely. The heightened sense of pain may be an outcome of depression (Alan D. Kaye, 2010). She has complained of pain due to the pneumonia that she is suffering from, her perception of her environment at the hospital depends on the empathy and participation in the care environment that she experiences. Clean surroundings, information posts and privacy and a participatory dialogue with the physician and nursing staff helps her establish a perception of confidence (LaVela SL1, 2015). A satisfied patient is more likely to think positively and this can change the way pain medication works. Psychosocial factors affect the coping mechanisms for pain in patients. This is particularly evident when placebos are administered in place of analgesics to relieve pain. A placebo is an inert substance that is therapeutic when administered in the context of the patient's medical condition. The patient's mind and body work in unison and there is an interplay of social contact with doctors and nurses besides the patient's beliefs, previous experience and manner of thinking. When a placebo is administered to alleviate pain it is an example of social interaction between the doctor and the patient. The trust that the patient has towards the doctor is the factor that helps in alleviating the pain. Relief in clinical symptoms observed following placebo interventions is observed due to physiological changes in the brain (Benedetti, 2013). The verbal communication between the doctor and patient can be directed towards altering patient's expectation of relief from the medication (Damien G Finniss, 2009). Mrs G also appears to be depressed and she may find it difficult to receive it is possible to put her at ease through communication with the nurse/carer. The communication can put the patient in a positive frame of mind and help the patient to derive more benefit from the prescribed treatment. Alleviation of pain can be achieved if the patient receives verbal inputs about how the prescribed treatment is working against the infection causing pathogen, which in Mrs G's case is pneumococcus. The simple act of listening by the nursing staff can reduce patient anxiety, fear and depression. An empathetic response to the patients questions can ease the patient's symptoms and feeling of sadness and helplessness and establish a relationship of trust that makes the patient hopeful of recovery from the medical condition. A positive mind-body change in Mrs G's case can help her recover from pneumonia and gain a positive state of mind. References: Alan D. Kaye, A. B. a. J. T. S., 2010. Pain Management in the Elderly Population: A Review. The Ochsner Journal, 10(3), p. 179187. Benedetti, F., 2013. Placebo and the New Physiology of the Doctor-Patient Relationship. Physiological Reviews, 93(3), p. 12071246.. Brian Merry, C. M. C. L. F. B. L. M. J. A. H. D. M. D. a. R. R. E., 2011. Ethnic Group Differences in the Outcomes of Multidisciplinary Pain Treatment. Journal of Musculoskeletal Pain, 19(1), p. 2430.. Damien G Finniss, M. K. N. a. F. B., 2009. Placebo Analgesia Understanding the Mechanisms and Implications for Clinical Practice. Reviews in Pain, 3(2), p. 519.. Edwards, C. M. C. a. R. R., 2012. Ethnic differences in pain and pain management. Pain Management, 2(3), p. 219230.. Fillingim, E. J. B. a. R. B., 2013. Sex differences in pain: a brief review of clinical and experimental findings. British Journal Of Anaesthesia, 111(1), p. 5258.. LaVela SL1, E. B. H. J. M. S., 2015. Patient Perceptions of the Environment of Care in Which Their Healthcare is Delivered.. Health Environments Research and Design Journal, p. 1937586715610577. Mogil, J. S., 2012. Sex differences in pain and pain inhibition: multiple explanations of a controversial phenomenon. Nature Reviews: Neuroscience, Volume 13, pp. 859-866 . Phelan SM1, H. R., 2015. Health professionals' pain management decisions are influenced by their role (nurse or physician) and by patient gender, age and ethnicity.. Evidence Based Nursing, 18(2), p. 58. Stanaway FF1, B. F. C. R. N. V. H. D. W. L. S. P. C. H. S. M. L. C. D., 2011. Back pain in older male Italian-born immigrants in Australia: the importance of socioeconomic factors.. European Journal of Pain, 15(1), pp. 70-6. Wandner LD1, H. M. L. B. H. A. G. S. H. A. A. J. T. C. R. M., 2014. The impact of patients' gender, race, and age on health care professionals' pain management decisions: an online survey using virtual human technology.. International Journal of Nursing Studies, 51(5), pp. 726-3.