Integrating Nonpharmacologic and Alternative Strategies into a Comprehensive Management Approach for Older Adults with Pain

Patricia Bruckenthal, PhD, RN, APRN-C

Stony Brook University School of Nursing
Stony Brook, NY

Pain in older adults is underreported and under-treated. Physical changes associated with getting older, increased cognitive impairment, and patient beliefs that pain is an inevitable consequence of aging are just a few of the factors that complicate pain management in this population. Further, the effective and safe use of analgesic medications in older patients is challenged by common comorbidities and polypharmacy. These complexities and the often incomplete efficacy of most pharmacologic agents for chronic pain require clinicians to consider complementary, alternative, and nonpharmacologic strategies when treating pain in older adults. Dr. Bruckenthal has categorized complementary and alternative medicine (CAM) into four domains: biologically based therapies, mind-body medicine, manipulative and body-based practices, and energy medicine. Here, Dr. Bruckenthal reviews appropriate implementation of CAM for older patients with chronic pain, including critical questions to consider when initiating CAM approaches in this population.

References

1) Bruckenthal P. Integrating nonpharmacologic and alternative strategies into a comprehensive management approach for older adults with pain. Pain Manag Nurs. 2010;11(2 Suppl):S23-31.
2) Herr K. Pain in the older adult: an imperative across all health care settings. Pain Manag Nurs. 2010;11:S1-10.
3) Austrian JS, Kerns RD, Reid MC. Perceived barriers to trying self-management approaches for chronic pain in older persons. J Am Geriatr Soc. 2005;53(5):856-61.

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