Skip to main content

The Assessment of Pain in Older People

  • Chapter
  • First Online:
Pain Management in Older Adults

Abstract

Pain assessment is a crucial step toward adequate management of pain in older adults. This chapter addresses the assessment of pain as part of a multidimensional stepwise approach. Although pain assessment uses standardized screening, assessment, and monitoring tools, it needs to be tailored to the individual patient. In the case of pain assessment in older adults, one size does not fit all is a fundamental principle. Pain is a personal and subjective experience because of numerous factors. A broad, inclusive approach to assessment is required. In this chapter several case studies highlight the differences and factors that need to be taken into account in the assessment of pain in older people.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 49.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 49.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • AGS (American Geriatrics Society Panel on Persistent Pain in Older Persons). The management of persistent pain in older persons. J Am Geriatr Soc. 2002;50:205–24.

    Article  Google Scholar 

  • Alfaro-LeFevre R. Applying nursing process. The foundation for clinical reasoning. Philadelphia: Wolters Kluwer Health; 2014.

    Google Scholar 

  • AMDA (American Medical Directors Association) Pain management in the long-term-care setting Clinical Practice Guideline. Columbia; 2012.

    Google Scholar 

  • Basler H-D, Bloem R, Casser HR, Gerbershagen HU, Griessinger N, Hankemeier U, et al. Ein strukturiertes Schmerzinterview fur geriatrische Patienten. Schmerz. 2001;15(3):164–71.

    Article  CAS  PubMed  Google Scholar 

  • BPS & BGS (British Pain Society and British Geriatrics Society). The assessment of pain in older people. 2007. https://www.britishpainsociety.org/static/uploads/resources/files/book_pain_older_people.pdf. Accessed 23 Mar 2017.

  • DNQP (Deutsches Netzwerk für Qualitätsentwicklung in der Pflege) [German Network of Quality Assurance in Nursing]. Expertenstandard Schmerzmanagement in der Pflege bei chronischen Schmerzen [National Standard of Pain Management in Nursing of Chronic Pain). Germany, Osnabrück; 2015. http://www.dnqp.de.

  • DNQP (Deutsches Netzwerk für Qualitätssicherung in der Pflege) [German Network of Quality Assurance in Nursing], Expertenstandard Schmerzmanagement in der Pflege bei akuten Schmerzen [National Standard of Pain Management in Nursing of Acute Pain). Germany, Osnabrück; 2011.

    Google Scholar 

  • Ferrell BA, Ferrell BR, Rivera L. Pain in cognitively impaired nursing home patients. J Pain Symptom Manag. 1995;10:591.

    Article  CAS  Google Scholar 

  • Free C, Phillips G, Felix L, Galli L, Patel V, Edwards P. The effectiveness of M-health technologies for improving health and health services: a systematic review protocol. BMC Res Notes. 2010;3:250. https://doi.org/10.1186/1756-0500-3-250.

    Article  PubMed  PubMed Central  Google Scholar 

  • German Pain Society & DZNE (German Pain Society & Deutsches Zentrum für Neurodegenerative Erkrankungen e.V.). Schmerzassessment bei älteren Menschen in der vollstationären Altenhilfe. [Pain assessment in older adults in long-term-care facilities]. Working Group “Pain and Age”. AWMF Leitlinie 145–001 2017. 2017

    Google Scholar 

  • Hadjistavropoulos T, Craig KD. A theoretical framework for understanding self-report and observational measures of pain: a communications model. Behav Res Ther. 2002;40(5):551–70.

    Article  CAS  PubMed  Google Scholar 

  • Hadjistavropoulos T, Herr K, Turk DC, Fine PG, Dworkin RH, Helme R, Jackson K, Parmelee PA, Rudy TE, Lynn Beattie B, Chibnall JT, Craig KD, Ferrell B, Ferrell B, Fillingim RB, Gagliese L, Gallagher R, Gibson SJ, Harrison EL, Katz B, Keefe FJ, Lieber SJ, Lussier D, Schmader KE, Tait RC, Weiner DK, Williams J. An interdisciplinary expert consensus statement on assessment of pain in older persons. Clin J Pain. 2007;23(SUPPL. 1):S1–43. https://doi.org/10.1097/AJP.0b013e31802be869.

    Article  PubMed  Google Scholar 

  • Hadjistavropoulos T, Fitzgerald TD, Marchildon GP. Practice guidelines for assessing pain in older persons with dementia residing in long-term care facilities. Physiother Can. 2010;62:104–13.

    Article  PubMed  PubMed Central  Google Scholar 

  • Häuser W, Schmutzer G, Henningsen P, Brähler E. Chronische Schmerzen, Schmerzkrankheit und Zufriedenheit der Betroffenen mit der Schmerzbehandlung in Deutschland. Schmerz. 2014;28:483–92.

    Article  PubMed  Google Scholar 

  • Herr K. Pain assessment strategies in older patients. Pain Manag Nurs. 2011;12(3):S3–S13.

    Google Scholar 

  • Herr K, Bjoro K, Steffensmeier J, et al. Acute pain management in older adults. Iowa City: University of Iowa Gerontological Nursing Interventions Research Center, Research Translastion and Dissemination Core; 2006. p. 113.

    Google Scholar 

  • Kaasalainen SK, Brazil N, Akhtar-Danesh E, Coker J, Ploeg F, Donald R, Martin-Misener A, Dicenso A, Hadjistavropoulos T, Dolovich L, Papaioannou A. The evaluation of an interdisciplinary pain protocol in long term care. J Am Med Dir Assoc. 2012;13:e661–8.

    Article  Google Scholar 

  • Klasnja P, Pratt W. Healthcare in the pocket: mapping the space of mobile-phone health interven tions. J Biomed Inform. 2012;45(1):184–98. https://doi.org/10.1016/j.jbi.2011.08.017.

    Article  PubMed  Google Scholar 

  • Kompetenz-Centrum Geriatrie beim Medizinischen Dienst der Krankenversicherung Nord. INFO – Service/Assessmentinstrument in der Geriatrie. 2009. www.kc-geriatrie.de/assessment_1.htm. Accessed 22 Mar 2016.

  • Lichtner V, Dowding D, Esterhuizen P, Closs SJ, Long AF, Corbett A, et al. Pain assessment for people with dementia: a systematic review of systematic reviews of pain assessment tools. BMC Geriatr. 2014;14:138.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lipschick G, Von Feldt J, Frame L, Akers S, Mangione S, Llewelyn H. American handbook of clinical diagnosis. Oxford: Oxford University Press; 2009.

    Google Scholar 

  • Lovel M, Luckett T, Boyle F, Phillips J, Agar M, Davidson P. Patient education, coaching, and self-management for cancer pain. J Clin Oncol. 2014;32(16):1712–20. https://doi.org/10.1200/JCO.2013.52.4850.

    Article  Google Scholar 

  • Lukas A, Mayer B, Onder G, Bernabei R, Denkinger MD. Schmerztherapie in deutschen Pflegeeinrichtungen im europäischen Vergleich. Schmerz. 2015;29(4):411–21.

    Article  CAS  PubMed  Google Scholar 

  • McCaffery M. Nursing practice theories related to cognition, bodily pain, and man-environment interactions. Los Angeles: University of California Students Store; 1968.

    Google Scholar 

  • McCaffery M, Pasero C. Pain: clinical manual. St. Louis: C. V. Mosby; 1999.

    Google Scholar 

  • McGeary DD, McGeary CA, Gatchel RJ. A comprehensive review of telehealth for pain management: where we are and the way ahead. Pain Pract. 2012;12(7):570–7.

    Article  PubMed  Google Scholar 

  • Melzack R. The McGill pain questionnaire: major properties and scoring methods. Pain. 1975;1(3):277–99.

    Article  CAS  PubMed  Google Scholar 

  • Melzack R, Wall P. The challenge of pain. London: Penguin Books; 1996.

    Google Scholar 

  • Osterbrink J, Hufnagel M, Kutschar P, Mitterlehner B, Krüger C, Bauer ZW, et al. Die Schmerzsituation von Bewohnern in der stationären Altenhilfe [The pain situation of residents in long-term care]. Schmerz. 2012;26:27–35.

    Article  CAS  PubMed  Google Scholar 

  • Reuschenbach B. Definition und Abgrenzung des Pflegeassessments. In: Reuschenbach B, Mahler C, editors. Pflegebezogene Assessmentinstrumente. Bern: Hans Huber; 2011. p. 27–46.

    Google Scholar 

  • RNAO (Registered Nurses Association of Ontario). Assessment and management of pain. 2013. http://rnao.ca/bpg/guidelines/assessment-and-management-pain. Accessed 22 Nov 2017.

  • Sirsch E, Gnass I, Fischer T. “Diagnostik von Schmerzen im Alter: Perspektiven auf ein multidimensionales Phänomen” [Diagnostics of pain in old age: perspectives on a multidimensional phenomenon]. Schmerz. 2015a;29(4):339–48.

    Article  CAS  PubMed  Google Scholar 

  • Sirsch E, Zwakhalen S, Gnass I. Schmerzassessment und Demenz – Deutschsprachige Ergebnisse eines europäischen Surveys. [Pain Assessment and Dementia, German results form an European survey]. Pflege und Gesellschaft. 2015b;4:316–32.

    Google Scholar 

  • Sloane PD, et al. Provision of morning care to nursing home residents with dementia: opportunity for improvement? Am J Alzheimers Dis Other Demen. 2007;22(5):369–77.

    Article  PubMed  Google Scholar 

  • Snow AL, O'Malley J, Cody KM, Kunik ME, Ashton CM, Beck C, et al. A conceptual model of pain assessment for noncommunicative persons with dementia. Gerontologist. 2004;44(6):807–17.

    Article  PubMed  Google Scholar 

  • Tsai P, Beck C, Richards K, Phillips L, Roberson P, Evans J. The pain behaviors of osteoarthritis instrument for cognitively impaired elders (PBOICIE). Res Gerontol Nurs. 2008;1(2):116–22.

    Article  PubMed  PubMed Central  Google Scholar 

  • Turk D, Melzack R. The measurement of pain and the measurement of people experiencing pain. In: Turk D, Melzack R, editors. Handbook of pain assessment. New York: Guilford Press; 2011. p. 3–16.

    Google Scholar 

  • Verenso (2011). Multidisciplinaire Richtlijn Pijn. Deel 1. Utrecht, Verenso.

    Google Scholar 

  • Wilkinson. Reference missing from reference list. 2007.

    Google Scholar 

  • Wilkinson J. Nursing process and critical thinking. Pearson: Upper Saddle River; 2012.

    Google Scholar 

  • Williams A, Craig K. Updating the definition of pain. Pain. 2016;157(11):2420–3. https://doi.org/10.1097/j.pain.0000000000000613.

    Article  PubMed  Google Scholar 

  • Wright S. Pain management in nursing practice. Los Angeles: Sage; 2015.

    Book  Google Scholar 

  • Zwakhalen SM, Hamers JP, Berger MP. The psychometric quality and clinical usefulness of three pain assessment tools for elderly people with dementia. Pain. 2006;126(1–3):210–20.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sandra Zwakhalen .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Fischer, T., Sirsch, E., Gnass, I., Zwakhalen, S. (2018). The Assessment of Pain in Older People. In: Pickering, G., Zwakhalen, S., Kaasalainen, S. (eds) Pain Management in Older Adults. Perspectives in Nursing Management and Care for Older Adults. Springer, Cham. https://doi.org/10.1007/978-3-319-71694-7_3

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-71694-7_3

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-71693-0

  • Online ISBN: 978-3-319-71694-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics