New guidelines for recognising and assessing pain in older adults
BGS, London (20 March 2018): New recommendations to help healthcare professionals recognise and assess levels of pain in older people were published today in the scientific journal Age and Ageing. The guidelines were developed by the British Geriatrics Society, the British Pain Society, the Royal College of Nursing, in collaboration with researchers at Teesside University, Anglia Ruskin University, University of Bournemouth, Centre for Ageing Better, and the Centre for Positive Ageing.
There is growing evidence to demonstrate that chronic pain is more prevalent among the older population and pain that interferes with everyday activities increases with age. Alleviating pain in the older population is therefore a priority but presents a number of challenges, especially in relation to communication with patients. These guidelines seek to address specific areas in which improvements can be made. To support this aim all existing publications on acute and chronic pain screening and assessment in adults over 60 years of age were identified, and two reviewers independently read and graded the papers according to the National Health and Medical Research Council criteria (1999b).
Specific areas that were identified as presenting a particular challenge when managing older people’s pain included ‘stoicism’ which can result in the under-reporting of pain, the perception that increasing pain is a natural part of ageing and 10 minute consultations in the UK general practice which often limits older adults from engaging in meaningful conversation about their pain. It was also noted that pain in nursing home residents often goes undetected.
These guidelines outline key recommendations regarding the detection and assessment of pain in older adults. Recommendations include recognising the fact that patient self-reporting is the most reliable and accurate measure and this includes older people with cognitive impairment. The guidelines also recommend that although older people often deny pain, the use of related terms, such as soreness, aching or discomfort may provoke a positive response. Re-wording questions to elicit the presence of pain such as “Do you hurt anywhere?” or “What is stopping you from doing what you want to do?” can substantiate the presence or absence of pain. Education and training of staff to recognise pain, and to act on their findings, is a key recommendation of the updated guidelines. It is advised that healthcare professionals be aware of the wide variety of pain measures available and a solid understanding of how and when to use them.
Professor Patricia Schofield, Deputy Dean for the Faculty of Health, Social Care and Education at Anglia Ruskin University and lead contributor of the Age and Ageing paper, said:
‘Pain in the older population has been largely neglected in the past, with the assumption that it is expected as you get older. This document sets out guidelines for the fundamental first step in the process, which is how we identify and measure pain in this population. Hopefully health and social care professionals will take on board the recommendations and we can move towards more effective pain management in the future.’
The Age and Ageing paper ‘Pain Assessment in the Older Population – where are we now?’ can be viewed here: https://academic.oup.com/ageing/issue/47/suppl_1
Notes to editors
To arrange an interview with Professor Patricia Schofield please contact Jamie Forsyth on 01245 684716 or email
These new guidelines are an update to the previously published Assessment of pain in Older People Guideline in 2007.
Age and Ageing is an international journal publishing peer reviewed original articles and commissioned reviews on geriatric medicine and gerontology. It is circulated to over 8,156 academic and healthcare institutions, with over 124,000 downloads a month and a growing citation rate (Impact Factor of 4.282 and ranked 9th in JCR Si: Geriatrics & Gerontology category). Its range includes research on ageing and clinical, epidemiological, and psychological aspects of later life. It is published by Oxford University Press on behalf of the British Geriatrics Society. Follow Age and Ageing on Twitter @Age_and_Ageing
The British Geriatrics Society (BGS) is the professional association of doctors practising geriatric medicine, nurses, therapists, researchers, GPs, old age psychiatrists and others engaged in the specialist care of older people and in promoting better health in old age. It has over 3,400 members and is the only society in the UK offering specialist medical expertise in the wide range of health care needs of older people. Follow The British Geriatrics Society on Twitter @gerisoc
The British Pain Society (BPS) is the oldest and largest multidisciplinary professional organisation in the field of pain within the UK. The BPS aims to make pain visible and to treat it better and is the British Chapter of the International Association for the Study of Pain. It is a registered Charity. Chronic pain is suffered by over a quarter of the population. It is commonly distressing and can be highly disabling. It is devastating for individuals who suffer it. Many cannot work and lose their jobs. Treatment of pain is a fundamental human right, yet sadly there is an enormous gap between the care people require and what happens in practice. We also do not know enough about the cause and treatment of pain. Our alliance of professionals works collaboratively with patients and industry partners to advance the understanding and management of pain. We strive to reduce the suffering of people enduring daily pain. Our multidisciplinary nature is pivotal in making The British Pain Society a uniquely relevant representative body on all matters relating to pain. It aims to promote education, training, research and development in all fields of pain. The Society is involved in all aspects of pain and its management through the work of the Council, various Committees, Special Interest Groups and Working Parties and via its publications, Annual Scientific Meeting and educational seminars.
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