Complexities of pain assessment in the elderly. Clinical considerations.

Establishing a trusting, caring relationship that acknowledges suffering and demonstrates caring is an important first step toward pain management in the elderly. The content of assessing pain in the elderly is similar to that for younger individuals. However, the source of information, manner and timing of assessment, method, and amount of data collected must be adapted to meet the special needs of the elderly individual. Strategies for assessing pain in the elderly must be adapted for those with sensory, cognitive, or psychomotor deficits. Many tools currently available for assessing pain may be effective when adapted to accommodate these changes. Interpreting reports of pain and pain-related behaviors in the elderly is complicated by myths and misunderstandings commonly held by the elderly and many health professionals. Careful consideration must be given to the meaning of pain or lack of pain report, as well as personal biases, which may influence the interpretation of pain behaviors.