Pain management in elderly persons who require assistance with activities of daily living: a comparison of those living at home with those in special accommodations

Objectives: To describe and compare the methods of pain management used by elderly individuals with chronic pain and requiring assistance with activities of daily living, depending on whether they live alone, with someone, at home or in special accommodations. Methods: This study comprised 294 people aged 76-100 years, identified as having chronic pain and requiring assistance with activities of daily living. Pain and pain management methods were compared using the Multidimensional Pain Inventory, Swedish version, and the Pain Management Inventory. Results: Those living in special accommodations reported more pain than those living at home. Those living with someone reported more pain and interference in daily life than those living alone, despite using more pain-relief methods and having greater social support. The median number of pain-relieving methods used was 3.0 (75th-25th percentile: 5-2). Some (3.8%) did not use any method to relieve their pain. The most frequently used methods were prescribed medicine (20%), rest (20%) and distraction (15%). The methods rated most effective were using cold, exercise, hot bath/shower and consuming alcohol. Conclusion: Participants had only a small repertoire of pain management methods and these were mostly conventional in nature. Few non-pharmacological methods were used. The findings suggest the importance of thorough assessment, and the need to fully discuss pain management options with the elderly. (C) 2003 European Federation of Chapters of the International Association for the Study of Pain. Published by Elsevier Ltd. All rights reserved.