Pain And Fatigue Of The Elderly

Dealing with aging dementia patients can be a challenge in and of itself. However, when healthcare providers need to include regulating pain as well, the challenge becomes even greater. Pain management with cognitively impaired patients is a constant problem within geriatric care in modern healthcare facilities (Zwakhalen et al 2006). The reduced self capacity to report pain in its true degrees then makes pain management a challenge for physicians and healthcare providers (Husebo et al. 2007). Thus, research aims to explore effective measures for observing and reporting pain management within aging dementia patients.

Nursing assessment is a substantial way of gathering physiological, psychological, spiritual, and emotional condition of the patient. It creates a whole picture of an individual and assist the health care providers to formulate a diagnosis. Assessing the comfort of the patient is equally important as taking the blood pressure or temperature. Pain is the fifth (5th) vital sign that is subjective in nature when performing an assessment of a patient. Various studies were conducted in finding the most appropriate evidence-based nursing practice in assessing and managing the pain of a cognitively impaired patient, whether it is acute or chronic or the underlying cause is cancer or post-operative incision. As emphasized by Song, Eaton, Gordon, Hoyle, and Doorenbos (2015), it is vital to ensure that “pain management is based on the best evidence” (p. 456). Perhaps knowing the causes of inability to assess and manage the pain in a cognitively impaired patient would give a clearer understanding of the practice.

Some patient’s were either on other pain medications or psychotropic medications and the nurse was unclear as to treat with medical therapy or non-medical therapy. This lack of knowledge can play in delay of treatment. Suggestions to overcome this were recommended for a pain management program. The change led to more patient routine pain scales being conducted but strategies were limited to show effectiveness since mostly non-pharmacologic measures were used. As a future advanced nurse practitioner, I believe that this article is useful to me and my career because it will remind me to use formulated pain scales and cues for pain based on the cognitive ability of the dementia of the patient. Despite the pain measures that the patient is already on, the patient should be treated appropriately for the pain that they are having. For instance, if their pain measures a 7 on the scale and they are receiving pain management scheduled and they are not due for a scheduled narcotic for another six hours then that patient should receive a PRN medication rather than a non-pharmacological

Pain is a complex and multidimensional phenomenon that is subjective and unique to each individual. Pain is difficult to describe and often hard to measure; however, most healthcare professionals agree that pain is whatever the patient describes it to be. Pain is one of the most frequently used nursing diagnosis and is the most common problem for which patients in the clinical setting seek help (Cheng, Foster, & Huang, 2003). Unrelieved pain can have a profound impact on the lives of both the patient and his or her family members. The subjective nature of pain makes pain difficult to assess; therefore, many patients do not receive adequate relief. The Joint Commission on Accreditation of Healthcare Organizations

In order to identify and prevent persistent pain in elderly population with dementia, Monacelly et al. (2013) conducted a study in a nursing home in Italy by using Doloplus-2 pain assessment tool. The participants were patients (n=23) with moderate to severe dementia and were unable to express the feeling of pain. Researchers obtained consent from the management and designated legal guardians of the patients. The purpose of the study was to observe the pain symptoms of the same group of elderly population for a period of one year and evaluate the effectiveness of the pain management by using the Doloplus-2 diagnostic pain assessment tool. As an initial part of the study, presence of pain was confirmed in participated patients by using the Doloplus-2

It is a challenge to manage pain in older adults. The course of action, effect and

In this study, I believe the independent variables are the stage of illness of the patient, spiritual well-being, and gender. The dependent variable fatigue during the cancer treatment. In the setting and subject description, the selection criteria had inclusion, and exclusion criteria. Within the inclusion criteria, every one of the participants had to be 18, or older, and have active cancer related treatment with a cancer diagnosis with either a palliative or curative intent, willing to participate in the study. The criteria that was excluded were those individuals whom had completed the cancer treatment those whom only received treatment only palliative care.

Participants completed a Brief Pain Inventory-Short Form within 24 hours of admission and every 48 hours until discharge. The nurse practitioners that gave the surveys reevaluated the patient’s feedback on a weekly basis. The study concluded that using the intervention of audit and feedback strategy, there was an increased compliance with using the CPGs (Dulko et al., 2010). There was also a significant increase in the documentation of the initial pain assessment and repeat assessments following a pharmacological intervention. Although the disease process of cancer patients cannot be avoided, it is imperative that this group of patients have substantial symptom control (Dulko et al.,

panel on pain assessment in older persons,13 have corroborated these conclusions.14 In particular, these authors highlight the need for more evaluation of observational pain measures, including validation against the criterion standard of self-report in intact and impaired populations. Almost all research on measuring pain in persons with dementia has focused exclusively on

Pain is a universal human experience and it is subjective. It is a major concern for those with cancer. One of the priorities of hospice is to provide comfort and a pain free death. It is however a concern that many people are still dying with uncontrolled pain. We are interested in hospice and pain management because hospice is known to be a place of comfort where individuals are provided with relief and allowed to die peacefully without pain. The majority of patients in the hospice settings are older adults with advanced cancer. Our goal is to create an intervention that will appropriately deal with the poor pain management experienced by many in hospice care. In order to help us with this task, four articles have been reviewed with regards to hospice and pain management.

Major themes associated with this study included: cancer pain, emotional pain, spiritual pain, pain management, and barriers to pain management.

Having worked in the oncology department in my organization for several years, I understand that cancer pain is intricate and compounded, managing cancer pain involves polypharmacy both pharmacological and non-pharmacological complementary and alternative therapy. Cancer patients, aching and discomfort trigger arrays of outpouring warning signs. With upsurge sign of pain ensues apprehension, while upsurge in apprehension ensues fretfulness and shortness of breath, the upsurge fretfulness and shortness of breath brings forth advanced fretfulness, which results in complex pain and anguish. It is imperative to treat cancer patient with pain early to avert and lessen other accompanied symptoms.

Previous research has indicated that the chronic pain is a common medical complaint among long-term care residents, which is often under-diagnosed and undertreated or inadequately treated. Natan, Ataneli, Admenko and Noy (2013) concluded the need of pain assessment training focusing on positive attitudes towards older adults as part of pre service-nursing career. The purpose of this descriptive correlational study was to identify factors predicting nurses’ performance of pain assessment among older long-term care residents and to examine variables associated with ageist attitude. Study was conducted among 104 nurses of long term care facility. Multiple linear regression analysis was done to examine the association between the variables.

Chronic pain in older adults is defined as ‘‘an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage, for persons who are either aged (65 to 79 years old) or very aged (80 and over) and who have had pain for greater than 3 months’’ (Lynch, 2000, p.270). The consequences of chronic pain may also be related to impaired activities of daily living (ADLs), physical disability, accidents, gait abnormalities, polypharmacy, and cognitive decline in older adults (Mantyselka et al., 2001; Kaye et al., 2010; Shega et al., 2010). Therefore, chronic pain has negative affects on older adults, their families, and social relationships.

The most common reason that people seek medical care is pain, and pain is the leading cause of disability (Peterson & Bredow, 2013, p. 51; National Institute of Health, 2010). Pain is such an important topic in healthcare that the United States congress “identified 2000 to 2010 as the Decade of Pain Control and Research” (Brunner L. S., et al., 2010, p. 231). Unfortunatelly, patients are reporting a small increase in satisfaction with the pain management while in the hospital (Bernhofer, 2011). Pain assessment and treatment can be complex since nurses do not have a tool to quantify it. Pain is considered the fifth vital sign, however, we do not have numbers to guide our interventions. Pain is a subjective expirience that cannot be shared easily. Since nurses spend more time with patients in pain than any other healthcare provider, nurses must have a clear understanding of the concept of pain (Brunner, et al., 2010). Concept analysis’ main objective is to clarify ideas, to enhance critical thinking, and to promote communication (Rodgers & Knafl, 2000). This paper will examine the concept of pain using Wilson’s Steps of Concept Analysis (Rodgers & Knafl, 2000).