AGING: Are these 4 pain myths complicating care?

Identify and counter these stereotypes. Avoid reinforcing stereotypes; counter them by summarizing these evidence-based findings for older patients. We believe patients would be receptive.

In one study, more than 80% of patients with osteoarthritis said they wanted prognostic information about the course of the disease, but only about one-third had received it.⁴⁷ Presenting the research findings would challenge patients’ stereotypes and help them reframe their expectations.

Elicit patients’ perspectives. Ask patients about age- and pain-related stereotypes and their expectations and perspectives of what constitutes successful treatment. Research shows that patients often wish to discuss lifestyle changes and nonmedical approaches to pain, for example, but that clinicians typically focus on medications instead.⁴⁸

Emphasize the positive. Frame discussions of pain and aging in a positive light, offering encouragement rather than supporting stoicism or resignation. Attention to protective factors, including good mental health, self-efficacy, social support, and greater activity, may enable older patients to adapt better to any pain they experience.

CORRESPONDENCE
Stephen Thielke, MD, MSPH, MA, University of Washington, Psychiatry and Behavioral Sciences, Box 356560, Seattle, WA 98195; sthielke@u.washington.edu