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This clinically focused book provides the essential modalities for managing pain in older patients. Chapters cover a variety of topics important for clinicians, including effective approaches, evaluation, acute and chronic pain, interventional strategies, and addiction issues. Complexities in assessing and treating pain when presented with multiple comorbidities and the unique physical, cognitive, and sensory changes that occur in the elderly are discussed in detail. Practical, concise and authored by leaders in pain medicine, this will serve as an invaluable guide to practitioners that care for older people.
This book will enable readers to understand the principles underpinning the management of pain which a particular emphasis upon the care of the older adult. The chapters will explore concepts that are recognised to be involved in the pain experience but each author will then add their own unique perspective by applying the principles to their specialist area of practice and the care of the older adult. It is structured to include the aims and outcomes of the chapter at the beginning so that readers can track their progress, and provides chapter outlines and further reading suggestions foir this unique topic area.
Highlights major new accomplishments in such areas as the neurobiology of pain, age-related psychological and cognitive differences in pain perception, and the assessment of pain in cognitively intact and cognitively impaired older persons. Treatments such as oral analgesics, physical therapy techniques, cognitive-behavioral therapy, complementary and alternative medicine applications, and multidisciplinary pain management clinics are discussed, as are low back pain, neuropathic pain, postoperative pain, and end-of-life issues.
Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.
Up-to-date information on pain management—including options to consider when conventional treatment is ineffective Providing effective treatment for pain-especially to elderly clients-can be a vexing problem for even the most knowledgeable clinician. In Clinical Management of the Elderly Patient in Pain, some of the world's leading authorities describe the unique difficulties that arise when trying to provide pain relief to elderly patients. They examine conventional treatment with opioid and non-steroidal anti-inflammatory drugs along with a broad range of alternatives to consider when frontline drugs fail. Non-drug options for pain relief from the fields of physical medicine and psychology are also explored. Essential topics addressed in Clinical Management of the Elderly Patient in Pain include: pain as an aspect of advancing age how pharmacology differs in elderly patients available therapeutic options, including opioids, non-steroidal anti-inflammatory drugs, anti-epileptic drugs, tricyclic antidepressants, membrane stabilizers, and topical agents physical medicine approaches psychological approaches to pain in the elderly Most publications on this subject focus on the use of opioids, non-steroidal drugs, and other commonly prescribed analgesics. Clinical Management of the Elderly Patient in Pain takes a different approach. Editor Gary McCleane, MD, says, “Our need, with elderly patients, is to provide treatment that is both effective and easily tolerated. This is not a book devoted to opioids and non-steroidals, although they are addressed. Nor is it about those analgesics used in younger patients being used in smaller doses with the elderly. Rather, it contains practical options for treating pain when other simple remedies fail to help. At times this will involve using conventional analgesics in scaled-down doses, but at others it will involve using substances not yet fully recognized as possessing analgesic properties because they fit the bill in terms of possible analgesic actions, side-effect profiles, and lack of drug/drug interactions—and because practical experience suggests they may be useful in the scenario described.” Clinical Management of the Elderly Patient in Pain is designed as a point of interface between the specialist pain practitioner and the clinician faced with all the problems of satisfactorily managing pain in elderly patients. It presents commonsense, practical, patient-oriented options that make it a useful resource for busy clinicians.
This book addresses relevant issues to enhance pain management nurses need to advocate for effective pain treatment in the elderly. Significant changes in the evolving nursing and healthcare environment require adequate information on this topic, as pain is a very challenging area. As other care professionals, nurses are daily confronted with issues on pain assessment and management. This volume offers an overview within an evolving health environment, in which nurses dealing with pain play a growing role. It showcases best practices in pain assessment and management, details non pharmacological and pharmacological treatments. It also addresses core issues defined by the International Association for the Study of Pain (IASP), such as knowledge translation, that are most relevant for clinical nurses, student nurses, nurse researchers as well as other care professionals.
A high percentage of patients with dementia experience debilitating pain. Untreated, it can result in mental and physical impairment; a higher frequency of neuropsychiatric symptoms such as agitation, depression, and sleep problems; and adverse events such as falls, hallucination, and even death. With the help of Pain in Dementia, you can learn new ways to give these patients a better quality of life! A multidisciplinary team of leading experts navigates the complex clinical challenges associated with pain among these patients. They identify the sources of pain, even in patients who have trouble communicating, and recommend the most effective pain treatment options.
Chronic pain costs the nation up to $635 billion each year in medical treatment and lost productivity. The 2010 Patient Protection and Affordable Care Act required the Department of Health and Human Services (HHS) to enlist the Institute of Medicine (IOM) in examining pain as a public health problem. In this report, the IOM offers a blueprint for action in transforming prevention, care, education, and research, with the goal of providing relief for people with pain in America. To reach the vast multitude of people with various types of pain, the nation must adopt a population-level prevention and management strategy. The IOM recommends that HHS develop a comprehensive plan with specific goals, actions, and timeframes. Better data are needed to help shape efforts, especially on the groups of people currently underdiagnosed and undertreated, and the IOM encourages federal and state agencies and private organizations to accelerate the collection of data on pain incidence, prevalence, and treatments. Because pain varies from patient to patient, healthcare providers should increasingly aim at tailoring pain care to each person's experience, and self-management of pain should be promoted. In addition, because there are major gaps in knowledge about pain across health care and society alike, the IOM recommends that federal agencies and other stakeholders redesign education programs to bridge these gaps. Pain is a major driver for visits to physicians, a major reason for taking medications, a major cause of disability, and a key factor in quality of life and productivity. Given the burden of pain in human lives, dollars, and social consequences, relieving pain should be a national priority.
Social isolation and loneliness are serious yet underappreciated public health risks that affect a significant portion of the older adult population. Approximately one-quarter of community-dwelling Americans aged 65 and older are considered to be socially isolated, and a significant proportion of adults in the United States report feeling lonely. People who are 50 years of age or older are more likely to experience many of the risk factors that can cause or exacerbate social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and sensory impairments. Over a life course, social isolation and loneliness may be episodic or chronic, depending upon an individual's circumstances and perceptions. A substantial body of evidence demonstrates that social isolation presents a major risk for premature mortality, comparable to other risk factors such as high blood pressure, smoking, or obesity. As older adults are particularly high-volume and high-frequency users of the health care system, there is an opportunity for health care professionals to identify, prevent, and mitigate the adverse health impacts of social isolation and loneliness in older adults. Social Isolation and Loneliness in Older Adults summarizes the evidence base and explores how social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly among low income, underserved, and vulnerable populations. This report makes recommendations specifically for clinical settings of health care to identify those who suffer the resultant negative health impacts of social isolation and loneliness and target interventions to improve their social conditions. Social Isolation and Loneliness in Older Adults considers clinical tools and methodologies, better education and training for the health care workforce, and dissemination and implementation that will be important for translating research into practice, especially as the evidence base for effective interventions continues to flourish.
Pain in later life is both quite common and disabling, and it differs significantly in terms of its aetiology, diagnosis and treatment from pain in the general adult population. Older people often have complicated co-morbidities, have a high prevalence of mental health problems (e.g., anxiety, cognitive impairment, and depression) and respond to treatment in different ways compared to younger people. Their specific needs are rarely discussed specifically in more general texts. Part of the "Oxford Pain Management Library," this pocketbook will serve as a concise companion for healthcare professionals who manage older patients suffering with pain. Concise chapters will summarise up-to-date research literature in a practical style that will have direct relevance to busy clinicians. Introductory chapters will include the epidemiology of pain in older people as well as the proper assessment of older patients with pain conditions. Later chapters will focus on specific painful conditions common in the elderly, including arthritis and rheumatism, osteoporosis, abdominal pain, and cancer. The book will appeal to a wide variety of health care professionals in both primary care and secondary care services such as geriatric medicine, rheumatology, orthopaedics, surgery, pain management and palliative medicine. The book will also be of relevance to nurses, physiotherapists, occupational therapists, clinical psychologists, pharmacists and other health care providers.