University of California, USA
Title: Pain management in geriatric patients
Diane Chau, is a practicing Geriatrician in San Diego, CA. Dr. Chau graduated from Drexel College of Medicine in 1994 and has been in practice for 21 years. She completed a fellowship in Geriatric Medicine at UCSD Medical Center. Dr. Chau also practices as the Medical Director of a Geriatrics focused Community Living Center at VA San Diego Health Care in San Diego, CA, and a Program of All Inclusive Care for the Elderly. She is an Associate Professor of Health Sciences Medicine at UCSD where she is the Project Director for the Geriatric Education Center Geriatric Workforce Enhancement Project.
- Understand how to define and classify pain in older adults
- List social and environmental factors affecting the perception of pain and its treatment common to older adults
- Recognize the scales available to assess pain
- List medical and non-medical treatments available for pain
- Median successful aging increased
- 65 years represents about 36 million; by 2020 54million
- Fastest growing segment of the population is > 85 years
- Currently 5 million, 20 million by 2050
- 1900’s - 3 million elderly (1 in 25 Americans), by 2020, 54 million (1 in 6 Americans)
- 2011 - first baby boomers reached 65
Mechanism of Pain Based on Pathophysiology:
- Nociceptive pain: Results from stimulation of pain receptors.
- Somatic: damage to body tissue, well localized
- Visceral: from viscera, poorly localized, may have nausea
- Neuropathic pain: Results from dysfunctions or lesions in either the central or peripheral nervous systems.
- Mixed pain syndromes: multiple or unknown mechanisms (e.g. headaches, vasculitic syndromes).
- Psychogenic Pain: somatoform disorders, conversion reactions.
Challenges of Pain Treatment in Geriatrics:
- The healthy to hospice span.
- A healthy retiree is no longer an individual who decreases their lifestyle activities.
- The "baby-boomers" in their 60s and 70s are "baby boomers"; they have a functional active lifestyle.
- The older old 80’s to 90’s are diverse. Functional ability, living situation, social support, restricted finances should be considered.