Multidisciplinary guideline 'Recognition and treatment of chronic pain in vulnerable elderly people'
Achterberg, W.P.; de Ruiter, C.M.; de Weerd-Spaetgens, C.M.E.E.; Geels, P.; Horikx, A.; Verduijn, M.M.
Nederlands Tijdschrift Voor Geneeskunde 155(35): A4606
2012
ISSN/ISBN: 1876-8784 PMID: 22929749 Document Number: 658988
Chronic pain in vulnerable elderly people is still poorly recognized and treated, both at home and in hospitals and care and nursing homes. Vulnerable elderly people experience and express pain differently to relatively healthy adults, especially when they suffer from cognitive impairment or specific conditions. Determining the nature and severity of the pain requires the use of pain assessment instruments that have been validated for use in vulnerable elderly people. Effective treatment of pain demands careful diagnosis and pharmacological and non-pharmacological interventions that have proven effectiveness in vulnerable elderly people. The combination of multiple morbidity and poly-pharmacy increases the chance of side-effects and complications. In addition, the pharmacokinetic and pharmacodynamic characteristics of many drugs are different in vulnerable elderly people. The advice is to start with a lower dose of pain medication and gradually build up a level on the basis of pain relief and side-effects ('start low, go slow!').