International Association for the Study of Pain®    IASP Press®

Editors: Betty R. Ferrell and Bruce A. Ferrell
1996, 152 pp, softbound, ISBN 0-931092-15-9. Price: $25.00 US [IASP members: $16.25 US]
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This book is the work of the IASP Task Force on Pain in the Elderly and outlines approaches to specific geriatric pain problems. Persistent pain is very common in elderly patients both because of the cumulative effect of progression of chronic painful diseases and because the frequency of many painful conditions increases with age. Individual elderly patients differ widely with respect to physiologic, psychologic, and socio-economic characteristics. Defining and treating pain in the elderly is often complicated by the existence of multiple medical problems and the increased incidence of treatment related side effects. This clinically oriented review will be helpful in practice and will serve as an impetus for additional education, research, and clinical concern for geriatric patients who suffer acute and chronic pain.

Table of Contents: Pain in the Elderly

Overview of Aging and Pain

Demography and epidemiology of human aging
Biology of aging
Pathophysiology of aging
Pain assessment in elderly people
Pain management strategies in the elderly

Pain in Older Adults: A Cognitive-Behavioral Perspective

Cognitive-behavioral model
Cognitive-behavioral treatment
Issues in using cognitive-behavioral therapy for pain management

Management of Chronic Pain in the Elderly: Pharmacology of Opioids and Other Analgesia Drugs

Age-related pharmacokinetics and pharmacodynamics
Age-related changes in opioid pharmacology
Chronic opioid therapy in the elderly
Age-related issues in NSAID therapy
Age-related issues in the use of adjuvant analgesics

Patient Education and Nondrug Interventions

Program development and implementation
Methods of nondrug intervention

Postoperative Pain Management in the Elderly

Barriers to effective postoperative pain management
Developing/implementing a postoperative pain management plan
Caring for complex elderly patients
Improving pain management

Cancer Pain in the Elderly

Epidemiology of cancer in the geriatric population
Barriers to pain management in the elderly
Pain syndromes/assessment
Treatment of cancer pain

Chronic Nonmalignant Pain in Older People

Clinical presentation of chronic nonmalignant pain in older people

Multidisciplinary Management of Chronic Nonmalignant Pain in Older Adults

Special considerations
Outcome studies of multidisciplinary pain treatment for the elderly

Pain Management for the Elderly in Alternative Care Settings

Issues and concerns related to alternate care settings
Pain management in the home
Barriers to effective pain management in long-term care facilities

Social Context of Elderly Chronic Pain Patients

Literature Review
Winnipeg Studies

An International Perspective on Pain in the Elderly


Contributing Authors

Steen Andersen, MD, Denmark; Pat M. Beaupré, PhD, USA; Andrew Cook, PhD, Canada; Michael J. Farrell, BAppSc(Phty), MGerontol, Australia; Betty R. Ferrell, PhD, FAAN, USA; Bruce A. Ferrell, MD, USA; Margaret C. Gibson, PhD, CPsych, Canada; Stephen J. Gibson, PhD, MAPsS, Australia; Robert D. Helme, MB BS, PhD, Australia; Keela A. Herr, PhD, RN, CS, USA; Benny Katz, MB BS, Australia; Francis J. Keefe, PhD, USA; Staporn Leelanuntakit, MD, Thailand; Jaime Olavo Marquez, MD, PhD, Brazil; Margo McCaffery, RN, MS, FAAN, USA; Paula R. Mobily, PhD, NR, USA; Chris Pasero, RN, BSN, MHSAc, USA; Beth Popp. MD, USA; Russell K. Portenoy, MD, USA; Ranjan Roy, AdvDip Soc Wk, Canada; Ilene C. Siegler, PhD, MPH, USA; Wendy M. Stein, MD, MA, NHA, USA; Michael Thomas, PhD, Canada; Debra K. Weiner, MD, USA; Hisashi Yanagida, MD, PhD, Japan

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. . . an excellent review of the pharmacology of opioids and other analgesic drugs with respect to the elderly. This contribution has several useful tables and is a fine review of the pharmacological literature. There are real pharmacological differences between the young and the elderly and the authors have highlighted these well.
. . . the authors have succeeded in crystallizing the important points [in the field of postoperative pain management in the elderly]. I would certainly recommend that any health care professional involved in the management of postoperative pain in the elderly patient should read this chapter.
. . . the authors have managed to summarize very many studies [of the problem of chronic non-malignant pain in elderly people] quite succinctly.
. . . this is a very useful volume which I feel is essential reading for any practitioner involved in the management of pain in the elderly. [It is] a useful contribution to the literature and comes highly recommended by this reviewer. British Journal of Anaesthesia

. . . provides a very good review of issues concerning pain management in elderly patients . . . The chapters dealing with the use of opioid and nonopioid drugs, patient education, multidisciplinary management of chronic nonmalignant pain and postoperative management of pain are particularly strong. This report should be in the library of every physician who cares for elderly patients. Canadian Medical Association Journal

. . . an excellent review of pain management in the elderly . . . This is a book for everyone who cares for the elderly with pain. Apart from immediate use, this book could inspire trainees (in many disciplines) to devote their talents to this important subject concerning the fastest growing population group in the country. Anaesthesia and Intensive Care

I would recommend the book to all who treat pain in the elderly. It gives both a good overview of the topic and practical advice for management. It will also be useful in the instruction of the upcoming generation of physicians and nurses. . . . Drug therapy is . . . detailed and well-discussed . . . A good survey of adjuvant analgesics such as antidepresssants and antiepileptics is given. Tidsskrift for den norske laegeforening
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This page was updated on August 17, 2001