Pain is uncomfortable for everyone, and is usually a sign of something more serious that needs to be dealt with – like another condition or a more serious injury.
Pain can be especially challenging for older people as they may have trouble communicating their discomfort.
For older people, pain needs to be assessed regularly, and the presence of pain (or inadequately controlled pain) should be investigated immediately.
To know how an elderly person is feeling, it’s important to look out for significant changes in the their condition or behaviour. It is also vital that such assessments happen routinely, at least every three months.
The best indicator of pain is the person’s own report of it. That is why those who are able to report pain, including people with mild to moderate dementia, need to be asked regularly about their condition and how they feel.
It should be noted that even for people with mild to moderate dementia, a verbal self-report of pain is more reliable than carer’s reports of pain.
A component of assessing pain is to assist the elderly person in describing their pain and take a pain history.
A pain history should include:
Location, radiation, quality, severity, aggravating and relieving factors and timing, as well as the their understanding of the pain and impact on their everyday activities.
To get a better understanding of their condition, and a more accurate pain history, there are specific questions you can ask.
- Show me where it hurts?
- Does it hurt anywhere else?
Note, this may be assisted by asking the resident to point to the pain. Use a body chart.
- Does the pain move anywhere?
- Would you describe the soreness or hurting as more like an ache, sharp or shooting?
- Describe the pain – is it aching, sharp, deep, shooting?
How the person describes their pain helps to identify the type of pain being experienced and therefore how best to treat it.
- Tell me about the worst pain or soreness, average pain/soreness, pain/soreness right now, pain/ soreness with movement.
Use pain scales to assist the resident rate pain severity and continue using the same scale in future assessments.
Aggravating and relieving factors
- What makes it hurt more and what helps most?
- When does it hurt most?
- Is it worse when you sit or move?
This identifies activities, medications and therapies that have or have not helped relieve the pain as well as coping skills used by the person.
- Is it worse in the morning or night?
- How long does it last?
- Does it come and go or is it there all the time?
The older person’s understanding of pain
Find out what the resident knows and feels about the pain, this will help you identify their understanding.
Impact of pain
- Does the pain affect sleep, appetite, physical activity, relationships with others, emotions, concentration?
Disclaimer: Please be aware the above article is merely information – not advice. If you need medical advice, please consult a doctor or other healthcare professional.