Regardless of whether patients live in the community or in a nursing home, treating their pain with opioids can raise concerns about sedation and cognitive impairment. The decision should involve an individualized risk-benefit analysis. “While opioids do increase the risk of sedation, confusion, falls, and constipation, for some people the analgesia that results outweighs these potential risks—and cognition actually seems to improve,” he said. “Perhaps they are less distracted by pain and are better able to focus and concentrate.”
Health care professionals should regard persistent pain in the elderly as treatable, with the potential for improvement in many patients. “We need to get the word out that the management of pain should be moved up the priority list, because we can get these patients feeling and functioning better,” Dr. Karp said.
Common Sources Of Geriatric Pain
Musculoskeletal
Degenerative joint disease
Spinal stenosis
Fractures
Improper positioning
Contractures
Visceral
Coronary artery disease
Urinary retention
Constipation
Neuropathic
Postherpetic neuralgia
Radiculopathy
Poststroke syndrome
Diabetic neuropathic pain
Metabolic
Vitamin D deficiency
Paget's disease
Other
Cancer
Fibromyalgia
Oral/dental disorder
Peripheral vascular disease
Polymyalgia rheumatica