Older People & Those Living With a Disability

Older people and those living with a disability have the highest rates of chronic pain in our community. One in three people aged over 65 are living with chronic pain, one in four people with a profound disability experience severe pain, and two in three people with a spinal cord injury are affected by ongoing pain. In residential aged care, 92 per cent of people are taking at least one analgesic medication daily and 80 per cent of people report pain as a problem.

Dementia and painful conditions often co-exist in older people and may be present in more than 25 per cent of people in the community and more than 50 per cent of people in residential aged care.

Chronic pain is a serious issue in people with impaired cognitive function. People who are unable to communicate their pain may be under-treated or inappropriately treated and therefore suffer unnecessarily. For people with dementia, it is estimated that pain may go undetected in as many as half of those with chronic pain conditions.

Under-treated or undetected pain can have serious adverse effects, including poorer cognitive performance, reduced quality of life, increased depression and greater functional disability. There may also be more frequent behavioural problems, such as aggression, wandering and disruptive vocalisation.

Whether the patient is older (with or without dementia) or lives with a disability, multidisciplinary pain management and if possible self-management will be most helpful for improvements in pain, mood and function.

Managing pain at end-of-life is also an important consideration. It requires much more than analgesic medication and should focus on preventing suffering. It should take into account physical and psychological factors as well as spiritual and cultural beliefs and attitudes towards dying.

If you are concerned about someone who may need treatment for pain, please consult your doctor. There are pain assessment tools that can be used, and strategies and therapies that can be put in place, to help bring pain relief.

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