Pain in the Elderly

Editors: Betty R. Ferrell and Bruce A. Ferrell
publish year: 1996
softbound, 152 pages
Task Force on Pain in the Elderly
ISBN 978-0-931092-15-2
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This book is the work of the IASP Task Force on Pain in the Elderly and
outlines approaches to specific geriatric pain problems. Persistent pain
is very common in elderly patients both because of the cumulative effect
of progression of chronic painful diseases and because the frequency of
many painful conditions increases with age. Individual elderly patients
differ widely with respect to physiologic, psychologic, and
socio-economic characteristics. Defining and treating pain in the
elderly is often complicated by the existence of multiple medical
problems and the increased incidence of treatment related side effects.
This clinically oriented review will be helpful in practice and will
serve as an impetus for additional education, research, and clinical
concern for geriatric patients who suffer acute and chronic pain.
Table of Contents
Overview of Aging and Pain
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Demography and epidemiology of human aging
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Biology of aging
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Pathophysiology of aging
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Pain assessment in elderly people
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Pain management strategies in the elderly
Pain in Older Adults: A Cognitive-Behavioral
Perspective
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Cognitive-behavioral model
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Cognitive-behavioral treatment
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Issues in using cognitive-behavioral therapy for pain
management
Management of Chronic Pain in the Elderly: Pharmacology of
Opioids and Other Analgesia Drugs
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Age-related pharmacokinetics and pharmacodynamics
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Age-related changes in opioid pharmacology
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Chronic opioid therapy in the elderly
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Age-related issues in NSAID therapy
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Age-related issues in the use of adjuvant analgesics
Patient Education and Nondrug Interventions
Postoperative Pain Management in the Elderly
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Barriers to effective postoperative pain management
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Developing/implementing a postoperative pain management plan
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Caring for complex elderly patients
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Improving pain management
Cancer Pain in the Elderly
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Epidemiology of cancer in the geriatric population
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Barriers to pain management in the elderly
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Pain syndromes/assessment
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Treatment of cancer pain
Chronic Nonmalignant Pain in Older People
Multidisciplinary Management of Chronic Nonmalignant Pain in
Older Adults
Pain Management for the Elderly in Alternative Care
Settings
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Issues and concerns related to alternate care settings
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Pain management in the home
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Barriers to effective pain management in long-term care
facilities
Social Context of Elderly Chronic Pain Patients
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Literature Review
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Winnipeg Studies
An International Perspective on Pain in the
Elderly
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Australia
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Brazil
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Canada
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Denmark
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Japan
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Thailand
Contributing Authors
Steen Andersen, MD, Denmark; Pat M. Beaupré, PhD, USA; Andrew
Cook, PhD, Canada; Michael J. Farrell, BAppSc(Phty), MGerontol,
Australia; Betty R. Ferrell, PhD, FAAN, USA; Bruce A. Ferrell, MD, USA;
Margaret C. Gibson, PhD, CPsych, Canada; Stephen J. Gibson, PhD, MAPsS,
Australia; Robert D. Helme, MB BS, PhD, Australia; Keela A. Herr, PhD,
RN, CS, USA; Benny Katz, MB BS, Australia; Francis J. Keefe, PhD, USA;
Staporn Leelanuntakit, MD, Thailand; Jaime Olavo Marquez, MD, PhD,
Brazil; Margo McCaffery, RN, MS, FAAN, USA; Paula R. Mobily, PhD, NR,
USA; Chris Pasero, RN, BSN, MHSAc, USA; Beth Popp. MD, USA; Russell K.
Portenoy, MD, USA; Ranjan Roy, AdvDip Soc Wk, Canada; Ilene C. Siegler,
PhD, MPH, USA; Wendy M. Stein, MD, MA, NHA, USA; Michael Thomas, PhD,
Canada; Debra K. Weiner, MD, USA; Hisashi Yanagida, MD, PhD, Japan
Reviews
"... an excellent review of the pharmacology of opioids and other
analgesic drugs with respect to the elderly. This contribution has
several useful tables and is a fine review of the pharmacological
literature. There are real pharmacological differences between the young
and the elderly and the authors have highlighted these well.
"... the authors have succeeded in crystallizing the important points
[in the field of postoperative pain management in the elderly]. I would
certainly recommend that any health care professional involved in the
management of postoperative pain in the elderly patient should read this
chapter.
"... the authors have managed to summarize very many studies [of the
problem of chronic non-malignant pain in elderly people] quite
succinctly.
"... this is a very useful volume which I feel is essential reading
for any practitioner involved in the management of pain in the elderly.
[It is] a useful contribution to the literature and comes highly
recommended by this reviewer."
British Journal of Anaesthesia
"... provides a very good review of issues concerning pain management
in elderly patients.... The chapters dealing with the use of opioid and
nonopioid drugs, patient education, multidisciplinary management of
chronic nonmalignant pain and postoperative management of pain are
particularly strong. This report should be in the library of every
physician who cares for elderly patients."
Canadian Medical Association Journal
"... an excellent review of pain management in the
elderly.... This is a book for everyone who cares for the elderly
with pain. Apart from immediate use, this book could inspire trainees
(in many disciplines) to devote their talents to this important subject
concerning the fastest growing population group in the country."
Anaesthesia and Intensive Care
"I would recommend the book to all who treat pain in the
elderly. It gives both a good overview of the topic and practical advice
for management. It will also be useful in the instruction of the
upcoming generation of physicians and nurses.... Drug therapy
is...detailed and well-discussed.... A good survey of adjuvant
analgesics such as antidepresssants and antiepileptics is given."
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