A Growing Need to Address Chronic Pain
“The Case for Killing Granny” was the title of a provocative September 2011 Newsweekarticle.1 Although it focused on end of life issues with cancer, the article brought out the concern—what happens to people as they age and suffer tremendous pain and disability?
Acute and chronic pain is a growing problem in the United States, affecting at least 116 million adults.2 Chronic pain, usually defined as persistent pain lasting more than 3 months, can be difficult to measure in the elderly due to underreporting and cognitive impairment. Nevertheless, it is one of the most common symptoms reported by adults over the age of 65. In fact, consider these statistics:
- studies have reported a prevalence of chronic pain in the elderly ranging from 38% to 50%
- the prevalence clearly increases with each decade of life and rates as high as 60% have been reported in adults aged 75 and over
- in 2008, Medicare spent over $65 billion on pain, and 14% of all Medicare costs are pain-related2,3
The problem with chronic pain in the elderly will grow as the population ages. It is estimated that 20% of Americans will be over the age of 65 by 2030, an increase from 12% in 2000.2
Chronic pain can have a dramatic effect on quality of life for older persons including physical, social, and psychological aspects. One study in adults over the age of 65 found significant differences in “satisfaction with life” between those who had pain and those who did not. The risk of depression increases with chronic pain, as does the risk of problems with sleep and appetite. In addition, severe pain can result in social isolation.2
The ability to function dramatically decreases with chronic pain. Both inpatients and community-dwelling older adults with chronic pain require additional assistance with activities of daily living (ADLs) such as cooking meals and getting dressed. Chronic pain has also been linked with increased falls. The reason for this is not clear, but one theory suggests that chronic pain may cause a person to alter their normal ADLs, causing loss of balance or loss of physical conditioning.4 Performing instrumental activities of daily living (IADLs) may also be an issue, resulting in significant disability.
AN INTERDISCIPLINARY APPROACH
Pain medicine is an expanding field and is now recognized as … http://www.rehabpub.com/issues/articles/2012-03_03.asp