Pain Management in Frail, Community-Living Elderly Patients

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Abstract
PAIN IS A COMMON problem among older people, with studies reporting a prevalence ranging from 45% to 80%, depending on age, the population studied, and the site of residence.1-3 Despite the widespread dissemination of the 3-level ladder of the World Health Organization (WHO)4 and the demonstration that pain can be alleviated in more than 90% of cases,5,6 pain continues to be inadequately addressed.7,8 Even patients with cancer, in whom pain might be most readily recognized, frequently receive poor treatment for pain.9 Furthermore, the needs of persons in some settings appear to be addressed especially inadequately, even when medical staff recognize that the patients are in pain. A recent study among residents of nursing homes with cancer found that one quarter of the patients did not receive any analgesic despite daily pain, and those older than 85 years were even less likely to receive analgesics.10