Pain Management for Older Adults: A Self-Help Guide
Heather D. Hadjistavropoulos
Publish Year: 2008
Format: softcover, 201 pages
List Price: US$29.95
Member Price: US$25.95
Pain Management in Older Adults: A Self-Help
Guide is designed to help older adults better understand and
proactively address their chronic pain problems.
Who should buy
With its self-assessment checklists, progress charts, photos and
illustrations, and easy-to-follow instructions for managing pain, this
book is an essential guide for:
- Older adults with chronic pain
- Physicians and other health care providers
- Physical therapists and fitness consultants
- Spouses, family members, and caregivers
Behind the Book
editors Thomas and Heather Hadjistavropoulos to describe why the book is
such an important resource.
Q: Is pain a natural part of growing old?
Thomas: Although pain accompanies many illnesses that affect older
people (such as osteoarthritis or cancer), it is not the result of old
age, but a consequence of disease, illness, or injury that needs to be
treated or managed. If we think of pain as a natural part of being old,
we may be less inclined to treat it effectively. Persistent pain needs
to be managed regardless of a person’s age.
Q: Do you see self-help strategies becoming more important as
the population ages?
Thomas: With the graying of the baby boom and advances in health care,
we are seeing a dramatic increase in the proportion of older adults in
society. There are many questions about the extent to which the health
care system will be able to meet the needs of the changing demographic.
While the effective management of pain will require health care system
resources in most cases, effective self-management has the potential of
reducing health care visits and the associated costs.
Q: What are some common misconceptions that older persons
have about their chronic pain?
Thomas: There are many of these. Sometimes people think of pain in old
age as being “natural” and something that needs to be
endured. Although pain problems are frequent in old age, they are never
“natural.” They are symptoms of disease or underlying
pathology and should be treated. Other examples include views that
analgesics and pain killers are the only line of defense against chronic
pain, whereas we know that a variety of approaches, including
psychological pain management strategies, can also play a key role in
Q: What is unique about Pain Management for Older Adults:
A Self-Help Guide?
Thomas: While there are several self-help books designed to help people
manage their pain and cope with associated stress, not much attention
has been paid, within the self-help literature, to the management of
pain among older adults. Older adults are different in many respects.
Age-related changes in our bodies result in the need for different
medication dosages. Recommendations for physical activity programs also
are different among older adults. Moreover, the types of stressors that
older adults face — such as empty nest syndrome and widowhood
— tend to be different from those of younger persons. As such, the
type of pain management and related stress management information needs
to be tailored to the context of the older adult. This is what we hope
we have accomplished with our book. The book brings together many
clinical experts, representing the disciplines of medicine, clinical
psychology, nursing, exercise therapy, kinesiology, dietetics, and
pharmacy with vast combined experience in the medical, psychosocial, and
physical management of chronic pain.
Q: What kind of clinical experience does each of you have
with older patients?
Thomas: My professional training is in clinical psychology. I began
clinical work with older adults approximately 18 years ago. After
noticing the high frequency of pain problems among older persons, I
became very interested in pain assessment and management among seniors.
My clinical work with older persons has focused on assessment and
psychosocial pain management (e.g., helping people deal with the
psychological consequences of chronic pain) in conjunction with regular
Heather: My clinical practice is quite diverse. Some of my practice
is focused on the psychological assessment of people who suffer from
chronic pain. I also provide psychological treatment to individuals who
have anxiety disorders, mood disorders, or adjustment disorder in
response to a medical condition. I use a cognitive-behavioral approach
in my work with clients. My work with older adults typically focuses on
facilitating adjustment to chronic medical conditions. This work often
involves assisting with development of strategies for dealing with pain,
depression, or anxiety. The work can also involve helping clients make
general changes in their health habits, such as increasing exercise,
eating better, or quitting smoking. At the University of Regina, I
started a Psychology Training Clinic a number of years ago. At this
time, I am exclusively supervising students who are interested in
working with older adults who are anxious about their health. This
anxiety about health is often triggered by experiences with pain from a
variety of medical conditions.
Q: What are some of the ways you keep readers motivated to
progress through the book and to start practicing the self-help
Thomas: We present the information in a language that lay people can
relate to and understand. As much as possible, we avoid scientific
jargon. Where appropriate, and always using lay language, the book makes
reference to scientific evidence that supports the effectiveness of
approaches discussed in the book. We include vignettes to illustrate
some of the problems and potential solutions that we discuss in the
book, and we encourage readers to move slowly as they practice the
coping skills discussed in the book. We also provide recording forms to
help people monitor their practice, progress, and successes over
Q: Do you have a particular story about a patient who used
some of the techniques you present in the book to make dramatic
improvements in his or her quality of life?
Heather: One client who really stands out for me is an older man who
suffered from chronic low back pain resulting from work injuries and
surgeries he underwent in his 40s. When I began to work with him, he was
extremely angry because he was in pain and he was at a point in his life
where he was “supposed to enjoy life.” He was still focused
on wanting someone to fix him, and frustrated that no one was willing to
operate on him. We used many of the strategies that are discussed in the
book. The key to working with him was to ask him to temporarily let go
of trying to get someone to operate on him and to start by having him
focus on what was in his control and what he could do to improve his
pain and life. We worked on changing negative thoughts, incorporating
relaxation strategies, scheduling pleasant events, improving his
communication with his family, and encouraging a healthy lifestyle. It
was the combination of all of the strategies that helped him; no one
strategy would have been effective on its own. One thing that was very
rewarding about working with this client was that when we started to
work together, he was very negative about seeing a psychologist and only
came to see me because his wife insisted. As we worked together,
however, he really opened up, and now he recommends psychologists to
everyone! He no longer even thinks about surgery. He has excellent
quality of life, spending time every day exercising, enjoying hobbies,
and being with his family.
Q: Why should physicians recommend this book to their older
Thomas: There are very few self-help pain management resources that are
specifically tailored for older adults. Most importantly, the book helps
foster a sense of control over one’s pain, and we know that people
who have an enhanced sense of control over their pain have better
outcomes. In addition to describing a variety of self-management coping
strategies, the book provides useful educational information about
topics such as pain management medication, sleep hygiene, and nutrition.
Physicians often provide such information to their patients, but time
constraints limit the amount of information they can provide. Having
such information available in written form can help patients understand
the information, while saving time in the medical office.
Q: What does this book mean to you personally?
Heather: It is very exciting to publish this book with Thomas. It is a
great way to mark our 20th wedding anniversary! The strategies that are
described in this book have benefited so many clients, and we are
pleased that the book will open up these strategies to many older adults
who would not normally learn about this approach to pain management.
Table of Contents
View Table of
- Pain among Seniors
Ronald R. Martin, Thomas Hadjistavropoulos, and Heather D.
- Pain and Psychology
Ronald R. Martin, Thomas Hadjistavropoulos, Jaime Williams, and
Heather D. Hadjistavropoulos
- Taking Control: Effective Pain Management
Ronald R. Martin, Thomas Hadjistavropoulos, Heather D.
Hadjistavropoulos, Sandra M. LeFort, and Shannon Fuchs-Lacelle
- Pain and Emotion
Sandra M. LeFort and Ronald R. Martin
- Social Support, Loneliness, and Pain
Ronald R. Martin
- The Role of Exercise in Seniors' Lives
Nancy K. Turner, Elizabeth L. Harrison, Robert McCulloch, and Ronald
- Living in More Comfort: Maximizing Function and Energy
Nancy Turner, Elizabeth L. Harrison, Robert McCulloch, and Ronald R.
- Sleep Hygiene and Nutrition
Ronald R. Martin, Sandra M. LeFort, Stephanie Cook, and Shannon
- Effective Communication with Your Doctor
Elan C. Paluck
- The Role of Medications
Romayne Gallagher, B. Lynn Beattie, and Ronald R. Martin
- Information for Caregivers of Older Adults Who Have Dementia
Thomas Hadjistavropoulos and Ronald R. Martin
Pain Management Review
Pain Management Resources from Around the World
< Hide Table of
a Review >
"The self-help program presented in this book was developed by pain
researchers and addresses seniors who experience chronic pain. ... The
book contains a number of tables, illustrations and, at the end of
chapter 1, a 4-page pain checklist which helps to define and
circumscribe the pain situation on an individual basis. There is also a
list of myths and untruths (such as pain is normal for the elderly,
etc.) which have to be dispelled to convince seniors to seek help and
efficiently take care of their pain. In the same way, chapter 2,
‘Pain and Psychology’ proposes a pain diary which helps to
define as precisely as possible the type, nature and intensity of pain.
Chapter 6 on exercise gives details with rich illustrations on movements
to be performed. The importance of natural posture is illustrated in
chapter 7, as well as the right way to set up the work place, as
postural problems play an important role in osteoarticular pain. The
book is very user-friendly. It deserves to be translated into other
European languages and distributed to organizations caring for elderly
Gerontology; May 26, 2009, reviewed by Dr. L.
Robert (read full review)
"This manual fills a niche with its specific focus on orientating the
information provided to the unique life circumstances of older adults.
... Health care professionals will find the guide very useful as a
support for treatment of older patients with persistent pain problems,
especially if they familiarize themselves with the checklists and other
tools, and make use of these resources to assist their patients in
building self-help capacity for pain management. Older adults who heed
the advice to use the manual in consultation with appropriate health
professionals will obtain the maximum value, but even those who elect to
use the manual independently will enhance their knowledge about
important lifestyle, behavioural and interventional-related issues that
influence the course and intensity of their persistent pain
Pain Research and Management (Volume 13, Number 5,
September/October 2008), reviewed by Maggie Gibson (read full review)
"I found this book to be very helpful. It offers self-assessment
checklists, progress charts, photos and illustrations, and simple
instructions for managing persistent pain."
The Pain Community News, newsletter of the American
Pain Foundation (Fall 2008,Volume 8, Issue 3), reviewed by Mary
"It is a pleasure to see a book aimed at those who suffer from
chronic pain that does not resort to alternative medical strategies of
little proven benefit. Furthermore, the book carries the strong message
that reducing one's pain is a function of the physical and psychological
work that the sufferer undertakes. ... I think that this book could be
an important accessory for those who provide care to the geriatric
APS Bulletin (Volume 18, Number 2, 2008), reviewed by
Dr. John D. Loeser (read full review)
"The authors are experts in their fields and the comprehensive
information [is] set out in a clear and usable manner. Professionals
might want to have this guide available and copy pages for their
patients. It would be a useful resource in residential care, as well as
being a 'bible' to any older adult with pain or caring for someone in
Alzheimers News, The National Newsletter of the
Alzheimers New Zealand Inc. (Issue 75, September 2008), reviewed by Dr.
"The text is carefully and clearly written with chapter-long
discussions of topics which often include useful charts and diagrams.
This reader-friendly book, which is published in ample-sized print, has
several strengths beginning with its sensitivity to older adults (not
simple referring to them in the title as 'seniors' as in other guides).
... Emphasis is given to realistic goals and resisting thoughts that
bring on depression and despondency."
Fibromyalgia Frontiers, The Quarterly Journals of the
National Fibromyalgia Partnership, Inc. (2008, Volume 16, Number
"I was impressed by this book. In clear language it describes what
pain is, how it should be assessed (questionnaires, scales, etc), and
how it can be effectively managed. There are chapters on the
psychosocial aspects of pain as well as the role of exercise and
nutrition. The sections on physical care and exercise are well
illustrated with photographs. In general, chronic pain is often not well
treated or fully appreciated, and I think this book would be a useful
resource for an older adult seeking practical solutions for managing
their chronic pain."
e-Newsletter from the International Association for Hospice and
Palliative Care, reviewed by Roger Woodruff, May 2008
About the Editors
Thomas Hadjistavropoulos, PhD, RD
Psych, is Professor of Clinical Psychology and Director of the
Centre on Aging and Health, University of Regina, Canada. Together with
his graduate students and collaborators, he has dedicated the last 16
years to investigating better ways of assessing and managing pain among
Heather D. Hadjistavropoulos, PhD, RD
Psych, is Professor of Psychology and Director of Clinical
Psychology Training at the University of Regina. She founded the
Psychology Training Clinic at the university and developed a
state-of-the-art Clinical Health Psychology Area for research, teaching,