Key Points

Sub-optimally managed pain can increase healthcare utilization and expenditures, contribute to family and caregiver distress, diminish quality of life and functional independence, and affect sleep, appetite, and even cognitive function.  Optimizing pain control in the elderly requires attention to several issues: (1) assessment of functional age, (2) effects of polypharmacy, (3) impact of comorbidities, and (4) comprehensive communication with the family and their support system.  A comprehensive pain assessment includes evaluation of not only physical pain but also any emotional, spiritual, or social components of pain. 


Pain Management Handout

Assessing Pain in Older Adults Powerpoint


Bosilkovska, M., Walder, B., Besson, M., Daali, Y., & Desmeules, J. (2012). Analgesics in Patients with Hepatic Impairment. Drugs, 72(12), 1645-1669. 

Delgado-Guay, M., & Bruera, E. (2008). Management of pain in the older person with cancer: Part 1: Pathophysiology, Pharmacokinetics, and Assessment. Oncology, 22, 56-61.  

Fallon, M., Cherny, N., & Hanks, G. (2011). Opioid analgesic therapy. In G. Hanks, N. I. Cherny, N. A. Christakis, M. Fallon, S. Kaasa, & R. K. Portenoy, Oxford Textbook of Palliative Medicine (pp. 661-698). New York: Oxford University Press.  

International Association for the Study of Pain. (2006). Pain: Clinical Updates; Older People's Pain.  

Johnson, S. J. (2007, November 30). Opioid Safety in Patients with Renal or Hepatic Dysfunction. Retrieved from Pain Treatment Topics:  

Mercadante, S., & Arcuri, E. (2007). Pharmacological Management of Cancer Pain in the Elderly. Drugs Aging, 24, 761-776.  

Pergolizzi, J., Boger, R., Budd, K., Dahan, A., Erdine, S., Hans, G., . . . Sacerdote, P. (2008). Opioids and the Management of Chronic Severe Pain in the Elderly: Consensus Statement of an International Expert Panel with Focus on the Six Clinically Most Often Used World Health Organization step III Opioids. Pain Practice, 8(4), 287-313.  

Portenoy, R. (2012, February). Pain. Retrieved from The Merck Manual Online:  

Rastogi, R., & Meek, B. (2013). Management of chronic pain in elderly, frail patients: finding a suitable, personalized method of control. Clinical Interventions in Aging, 8, 37-48.  

Schmader, K. E., Baron, R., Haanpaa, M. L., Mayer, J., O'Connor, A. B., Rice, A., & Stacey, B. (2010). Treatment Considerations for Elderly and Frail Patients with Neuropathic Pain. Mayo Clin Proc, 85(3), S26-S32.  

Yennurajalingam, S., Braiteh, F., & Bruera, E. (2005). Pain and Terminal Delirium Research in the Elderly. Clinics in Geriatric Medicine, 21, 93-119.  

Zeppetella, G. (2011). Breakthrough Pain. In G. Hanks, N. I. Cherny, N. A. Christakis, M. Fallon, S. Kaasa, & R. K. Portenoy, Oxford Textbook of Palliative Medicine (p. 655). New York: Oxford University Press.