Compact Clinical Guide to Geriatric Pain Management

Ann Quinlan-Colwell, PhD, RNC, AHNBC, DAAPM, works as Pain Management Clinical Nurse Specialist at New Hanover Regional Medical Center, Wilmington, NC. She serves as a pain management consultant, a leader influencing policy and procedure development, educator for patients, families, nurses and other health care providers, researcher in pain management and nursing care, and provider of clinical care. She is also chair of the nursing research committee. Dr. Quinlan-Colwell has had extensive pain management experience in clinical and coordinator roles at Duke University Medical Center, hospice, palliative, and home health care with several agencies including UNC-Chapel Hill and Duke Hospice and Palliative Care, and Castle Point VA Medical Center (NY). She currently is certified in pain management nursing (ANCC), Advanced Holistic Nursing (AHNBC), and holistic stress management instruction and is a diplomat in the American Academy of Pain Management. She has published several articles in peer-reviewed nursing journals as well as book chapters on therapeutic touch and acute pain management. She has presented her research nationally and internationally and routinely addresses health care professionals on various aspects of pain management. ||Yvonne D'Arcy, MS, CRNP, CNS, is the Pain Management and Palliative Care Nurse Practitioner at Suburban Hospital- Johns Hopkins Medicine in Bethesda, Maryland. She has served on the board of directors for the American Society of Pain Management Nurses and has played an integral role in the formulation of several guidelines on the management of acute and chronic pain. She is a Principle Investigator at Suburban Hospital for several studies to include the use of EMLA to reduce pain in elderly patients when IVs are placed. and the Dissemination and Implementation of Evidence -based methods to Measure and Improve Pain Outcomes. Ms. D'Arcy is also the recipient of the Nursing Spectrum Nursing Excellence Award in the Washington DC, Maryland, and Virginia districts for Advancing and Leading the Profession. She has contributed to numerous books and journals throughout her career. Books include Pain Management: Evidence-Based Tools and Techniques for Nursing Professionals, Compact Clinical Guide to Chronic Pain, and Her book, How to Manage Pain in the Elderly is an American Journal of Nursing book of the year for 2010.Her books, A Compact Clinical Guide to Cancer Pain co-authored with Pamela Davies, and A Compact Clinical to Women's Pain, are scheduled for a 2012 publication. Ms D'Arcy lectures and presents nationally and internationally on such topics as chronic pain, difficult-to-treat neuropathic pain syndromes, how to teat pain in the elderly, and all aspects of acute pain management. Articles she has published can be found in an extensive number of journals, including but not limited to American Nurse Today, Nursing 2011, Pain Management Nursing, PT Insider, and Nurse Practitioner Journal.

Foreword

Preface

Acknowledgments


SECTION I: AN OVERVIEW OF PAIN IN THE OLDER ADULT


1. Physiological Factors and Pain Processing in the Older Adult


2. The Psychosocial Impact of Pain on the Older Adult Patient


SECTION II: ASSESSING PAIN IN THE OLDER ADULT


3. Pain Assessment in the Older Adult Patient


4. Assessing Pain in the Nonverbal, Cognitively Impaired Older Adults


5. A Review of Pain Assessment Tools for Use with the Older Adult Patient


SECTION III: MANAGING PAIN IN THE OLDER ADULT


6. Developing a Comprehensive Plan for Managing Pain in Older Adults


7. Choosing the Right Medication for the Pain Complaint


8. Adjuvant Analgesic Medications


9. Managing Medication Side Effects and Specific Recommendations for Using Medications with Older Patients


SECTION IV: OTHER TREATMENT OPTIONS FOR PAIN RELIEF


10. Interventional Options Such as Vertebroplasty for Compression Fractures, Nerve Blocks, and Acupuncture


11. Complementary Interventions for Pain Management in Older Adults


12. The Role of Physical Therapy with Pain and Reconditioning


SECTION V: PAIN CONTROL FOR END OF LIFE CARE


13. Palliative Care: Techniques to Promote Comfort


14. When Is Hospice the Best Option?


SECTION VI: PAIN CONDITIONS COMMON IN OLDER ADULTS


15. Osteoarthritis and Gout


16. Chronic Back Pain and Osteoporosis


17. Neuropathic Pain Associated with Postherpetic Neuralgia and Diabetic Neuropathy


18. Central Poststoke Pain Syndrome


19. Facial Pain Associated with Temporal Arteritis and Trigeminal Neuralgia


20. Rheumatological Conditions


21. Fibromyalgia


SECTION VII: SPECIAL CONSIDERATIONS IN MANAGING PAIN IN OLDER ADULTS


22. Anxiety and Depression with Pain in Older Adults


23. Alcohol and Substance Use, Misuse, and Abuse


Index