Pain Medicine in Older Adults: How Should It Differ?

Abstract

Older adults (commonly defined as those > age 65) are not simply a chronologically older version of younger patients. Homeostenosis, that is, progressive restriction of an aging organism's capacity to respond to stress because of diminution of its biological, psychological, and social reserves, underlies the distinction of old from young. As pain is a stressor that commonly accompanies aging, the provision of safe, clinically effective, and cost-effective pain care to older adults requires awareness of these specific aging-related changes. The main goals of this chapter are to (1) educate the pain practitioner in basic principles of aging needed to guide the evaluation and treatment of older adults, (2) provide clinical case examples to illustrate the advantages of treatment that is guided by these principles as compared with traditional pain care and why traditional pain care may actually harm these patients, and (3) offer specific therapeutic guidelines for the treatment of nociceptive, neuropathic, and widespread pain in older patients. (PsycINFO Database Record (c) 2015 APA, all rights reserved)