Hebrew SeniorLife Home Care specializes in the care of older patients, and in my experience, the majority of my patients experience some degree of pain. It can range from mild, daily arthritic discomfort and stiffness to severe pain associated with surgery or trauma such as a fall, and in some cases, a disease like cancer or diabetes. Whatever the cause or level of severity, pain can cause a ripple effect that touches relationships and profoundly affects an individual’s quality of life.
For these reasons, it is important to take a holistic approach when assessing an individual’s pain and developing a treatment plan for chronic pain management. Of course my team always starts a visit by asking about the nature, severity and location of a patient’s pain. But, beyond that we consider very carefully how the pain is impacting daily life.
Arthritic pain may make simple tasks like opening a jar difficult, which is important if cooking brings pleasure to a patient’s life. Osteoarthritic pain that affects a knee joint may limit mobility. The pain, or even fear of pain, may cause a patient to become sedentary and socially isolated. Both of these scenarios over time can lead to depression. It becomes clear to see how pain can start a cascade of events that lead to decline in an older adult if not properly treated.
Helping our patients manage pain at home is part and parcel of the care we routinely deliver. However, particularly with older patients, it is important to customize treatment to the individual. We work very closely with a patient’s primary care physician to make sure treatment is safe and effective. Many of our older patients suffer from more than one chronic condition and are already taking multiple medications. This means we need to ensure that any suggested pain medication will not cause unsafe or uncomfortable side-effects.
There are also a wide range of non-drug treatments available in our arsenal to combat pain. Most happen in the home and run the gamut from ice and heat, to exercise, to massage, to guided imagery that helps an individual relax. We may also recommend acupuncture or specialized therapies such as aquatherapy or yoga, in which case we will make a referral to a trusted outside facility, including options within the HSL continuum.
Bottom line —as key to maintaining independence and maximizing quality of life, pain management should always be an important part of any home care plan.