Chronic Pain in Older Adults

Chronic Pain in Older Adults. Chronic pain is one of the greatest issues affecting the healthy aging of Canadian adults. Managing chronic pain among the older adults can be a challenging process, but approaches to treatment that are tailored to each individual’s uniqueness can be very effective. In some cases, multidisciplinary nursing interventions are often necessary to address certain aspects of chronic pain experiences. Some of the objectives chronic pain management is to improve the well-being of the older adult and quality of life. As much as most chronic pain management involve the use of pharmacological, certain non-drug, or non-pharm logical therapies may also be considered in conjunction with the pharmacological. For instance, some of the nursing interventions may include cognitive behavioral therapy, lifestyle redesign and meditation for older adults. Registered nurses in Canada have a responsibility of also addressing the holistic needs of older adults despite certain potential barriers that need to be considered when implementing the interventions.
Introduction
Chronic pain is normally defined as a pain that lasts for more than twelve weeks. It often persists for months or even longer. It is a common problem for adults. Apart from discomfort, it can also lead to impaired sleep, decreased appetite, depression and decreased the quality of life. Chronic low back pain, for instance, is a disabling condition, with over 70% of the people suffering from the health problem at one point in their lives (Herr, 2002).

The health condition can arise from initial injuries like a back sprain or ongoing causes such as illness. Sometimes there is no clear cause. Health challenges such as decreased appetite, fatigue, sleep disturbances and mood changes normally accompany chronic pain. It may limit movements of a person, flexibility, strength, and stamina.
Understanding various aspects of chronic pain is important for the health of Canadian older adults because it promotes patient education as well as the implementation of behavior changes that contribute to better health. The issue is also important to nursing practice because it helps provide safe and competent care and promote the health and well-being of the public. The nursing profession is expected at all times to act in the public’s best interest and to maintain public protection. The paper brings out the evidence-based interventions of chronic pain of the aging of Canadian adults and the role of role of nurses when addressing this issue.
Strategies to Promote/Protect Health
Cognitive Behavioral Therapy
According to the study Katherine Beissner and Charles Henderson, barriers to CBT intervention may include time constraints, reimbursement concerns, lack of knowledge and skills in this intervention (Beissner & Henderson, 2009). Based on the study, the physical therapists who were the respondents showed substantial interest in incorporating this technique into practice despite only a minority of them reported the use of certain CBT techniques while treating patients with chronic pain. The data obtained from the above study is reliable and credible. The survey was completed by 152 members of “Geriatrics and Orthopaedics sections of the American Physical Therapy Association” (Beissner & Henderson, 2009). The study assessed the association between the participant-related factors and interests in cognitive behavioral therapy in statistical linear models. In other words, evidence regarding this intervention is reliable and credible despite certain limitations that have been mentioned above.
Lifestyle Redesign
The intervention is based on a study conducted by Ashley Simon and Chantelle Collins. Lifestyle Redesign involves the use of modules or topics to promote the implementation of behavior change and patient education. It focuses on facilitating the development of patient’s healthy self-care habits and routines to manage or prevent chronic conditions. Based on the recent manual done by Clark in 2015, lifestyle redesign approaches includes didactic presentations, direct experience, peer exchange and personal exploration (Uyeshiro Simon & Collins, 2017). The intervention focuses on occupational self-analysis, patient education, motivation building, implementation of behaviors and problem-solving. However, a study by Ashley Simon and Chantelle Collins also had certain limitations. First, the delivery of treatments greatly differed as a result of cost, patient burden, and time constraints despite methodological similarities the manual and this analysis (Uyeshiro Simon & Collins, 2017). The second limitation is the interference by other therapies such as psychology and physical therapy on outcomes. The data concerning the patients that were attending psychology or physical therapy were not available. Thus it couldn’t be accounted for in the analysis. Despite those limitations, evidence regarding this intervention is reliable. The credibility of the resource can also be ascertained. The module topics, as well as durations of treatments on the modules, were determined by the evaluation of the therapists and continuous assessment of patients’ needs.
Meditation for Older Adults
Recent studies have given evidence that meditation leads to certain observable changes in the brain that relates to memory, stress, sense of self and empathy (Sorrell, 2015). Meditation may be taught through a wide range of exercises, with meditators sitting quietly while enhancing awareness of what’s happening in mind and focusing on their breathing. Nurses need to consider mindfulness training as a useful intervention for older adults, having certain health problems such as chronic pain, anxiety, depression, caregiver burden, and loneliness. Research conducted by Jeanne Sorrell confirms that mindfulness training can assist older adult to manage physical and psychological challenges of aging in a way that promotes vitality and reduces distress (Sorrell, 2015). Despite the increasing evidence of the usefulness of mindfulness-based intervention, the applicability of the approach has received little attention as far as psychological research literature is concerned. The information that led to the conclusion of this study can be considered reliable because the authors relied largely on the secondary data to build up their arguments. The resource can be said to be credible because it is based on scientific studies and evidence which helps ascertain the arguments.
The Nurse’s Role in Health Promotion
A nurse has certain roles when addressing this issue in healthy aging. They often provide team-based care which is critical in managing the growth rates of chronic diseases. In Canada, over 40% of adults report at least one chronic condition such as heart disease, arthritis, cancer and high blood pressure among others (Baker & Lamont, 2015). The role of a nurse involves primary care which is facilitated by team-based care. They also conduct formal research, manage nursing activities, contribute to advancements in public health policy and develop and delivering of nursing education.
Registered nurses in Canada practice in all the territories and provinces across five domains which include administration, education, research, clinical care, and policy. In various settings of healthcare, they care for people around the clock (Baker & Lamont, 2015). They have a responsibility of also addressing the holistic needs of older adults which includes physical, social, psychological spiritual and cultural needs.
It is vital to note that there are certain potential barriers for nurses to consider when implementing the interventions. The barriers may include the lack of basic knowledge about strategies of pain management and the high cost of treatments. Such barriers can be overcome by exploring the available treatment options and interventions of primary care physician to improve the patient’s life.
Summary and Conclusion
Chronic pain is one of the conditions that are normally attributed to old age. The impact and prevalence of chronic pain among the aging adult in Canada warrant serious attention. There are various nursing interventions for chronic pain of the aging which can help address the health issue. Some of these interventions that have been discussed include cognitive behavioral therapy, lifestyle redesign and meditation for older adults. A vital aspect of these interventions is the possibilities of reducing or helping to avoid certain medications that are normally a challenge with this population.
Proper understanding various aspects of chronic pain is important because it promotes patient education as well as the implementation of behavior changes that contribute to better health. Considering a range of conditions of chronic pain, individuals need to be given in-depth patient education and also tailoring interventions to address specific lifestyle factors. Physicians and nurses are in a position to address the problem of chronic pain but must first overcome various barriers that may obstruct effective treatments.
Literature Research strategy
The target population for this term paper was the Canadian population which is at risk of developing chronic problems. The research strategy was based on secondary data which both theoretical and practical analysis of various aspects of chronic pain. We conducted a web search and came up with relevant articles on the subject of chronic pain as well as nursing interventions. The keywords for the web search were “chronic pain in older adults in Canada” and “Nursing interventions for chronic pain.” The aim was to analyze various evidence-based interventions of chronic pain of the aging of Canadian adults and the role of role of nurses when addressing this issue.
Based on my practical consideration, I came up with exclusion and inclusion criteria to determine potentially relevant articles. An article had to address certain key issues that were under consideration in this paper. The article also had to be a peer-reviewed article for it to be included as one of the sources for the issue. The priority was given to articles that provided primary data from controlled, randomized trials. However, systematic reviews were also included to find out whether they had certain additional information that was not covered by the primary controlled, randomized reports.
Reference
Baker, C., & Lamont, L. (2015). Framework for the practice of registered nurses in Canada(2nd ed.). Ottawa, ON: Canadian Nurses Association.
Beissner, K., & Henderson, C. (2009). Physical Therapists’ Use of Cognitive-Behavioral Therapy for Older Adults With Chronic Pain: A Nationwide Survey. Physical Therapy, 89(5), 456-469. http://dx.doi.org/10.2522/ptj.20080163
Herr, K. (2002). Chronic Pain in the Older Patient: Management Strategies. Journal Of Gerontological Nursing, 28(2), 28-34. http://dx.doi.org/10.3928/0098-9134-20020201-08
Sorrell, J. (2015). Meditation for Older Adults. Journal Of Psychosocial Nursing & Mental Health Services, 53(5), 15-19.
Uyeshiro Simon, A., & Collins, C. (2017). Lifestyle Redesign® for Chronic Pain Management: A Retrospective Clinical Efficacy Study. American Journal Of Occupational Therapy, 71(4), 7104190040p1. http://dx.doi.org/10.5014/ajot.2017.025502