Sunday, January 15, 2006

pain management

The sensory experience of pain can be categorized as acute pain or chronic pain. Acute pain accompanies an active illness or injury and disappears when the individual recovers from the primary condition. It serves as a warning signal and alerts the patient and physician that something is wrong. All attempts are made to render the patient as comfortable as possible while the primary disorder is diagnosed and treated.
Chronic, or protracted, pain presents a different situation. Many patients with chronic pain have no discernible lesion or illness. More commonly, the severity of the pain is not explained by the disease that is detected. This is commonly found in geriatric patients who face many loses in their life, which force them to constantly adapt to new situations. It becomes easier for them to focus on physical symptoms rather than on the feelings of their loss.
However, it is unquestioned that the elderly must deal more often with chronic pain as a direct result of specific painful physical disorders such as intractable (uncurable) cancer.
Proper therapeutic management is of prime importance with administration of medication on a regularly prescribed schedule rather than sporadically when pain is at its worst.
The patient needs to accept the reality of the effects of chronic pain and the adjustments necessary to cope with daily life. The ability to sleep, the working quality of family life, the degree of independence, and the quality of interpersonal relationships all indicate the degree of adaptability. To achieve this level it may be necessary for some patients to seek psychotherapy either on an individual basis, in group therapy or family counseling.
For many patients with chronic pain, the regular visit to the family physician can be helpful. A sympathetic, caring doctor who can understand what they are suffering and empathize with them can have great meaning to the elderly patient. Family, recreational and church activities are other ways that maintain a patient's involvement with life. The more involved a patient is with other people and activities the less involved will he or she be with matters of pain and illness.
Covington, T., and Walker, J. Current Geriatric Therapy. Philadelphia: W. B. Saunders, 1984.

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