Easing elders' pain

Foot Reflexotherapy Induces Analgesia in Elderly Individuals with Low Back Pain: A Randomized, Double-Blind, Controlled Pilot Study

Introduction

This study evaluated the effects of foot reflexotherapy on pain and postural balance in elderly individuals with low back pain.

Design

Randomized, controlled pilot study. Participants (n = 20) were randomly assigned to 2 groups: individuals submitted to conventional foot massage (control group) or foot reflexotherapy (RT, intervention group) for a period of 5 weeks. Questionnaires on pain and disability (visual analogue scale [VAS] and Roland-Morris Disability Questionnaire [RMDQ]), heart rate variability, and orthostatic balance and baropodometric analysis were assessed at two intervals: before and after intervention.

Results

RT group showed statistically significant differences when compared to control group in the following parameters: decrease in VAS scores for pain throughout the study, decrease in parasympathetic activity, and improvement in RMDQ scores. The two groups did not statistically differ in either orthostatic balance or baropodometric analyses.

Conclusion

This study demonstrated that foot reflexotherapy induced analgesia but did not affect postural balance in elderly individuals with low back pain.

The Quality of Pain Treatment in Community-Dwelling Persons with Dementia

BACKGROUND/AIMS

Despite pervasive and debilitating pain among elders, it is underassessed and undertreated; and cognitive impairment can add challenges. We assessed the quality of pain care for community-dwelling elderly patients with dementia.

METHODS

We phone interviewed 203 Veterans Affairs primary care outpatients with dementia and pain and reviewed medical records to score 15 quality indicators of pain assessment and management.

RESULTS

Pain assessment was documented for 98%, and a standard pain scale was used for 94%. Modified pain scales were rarely used. Though 70% self-reported pain of 'quite bad' or worse, charts documented no pain in 64%. When pain was identified, treatment was offered to 80%; but only 59% had a follow-up assessment within 6 months. Nonpharmacological interventions were underused.

CONCLUSION

Community-dwelling elders with dementia are underdiagnosed and undertreated for pain.

Mensuração da dor no idoso: uma revisão

A base teórica e prática da mensuração de dor em idosos foi revisada e examinada através de estudos clínicos e revisões bibliográficas. As vantagens e limitações dos instrumentos ordinais mais freqüentemente utilizados foram discutidas em situações nas quais coexistem alterações próprias do envelhecimento, cuja ação na sensação dolorosa ainda não está bem esclarecida. Os fatores que interferem no processo de avaliação da experiência dolorosa, levando à subestimação e controle inadequados da dor em indivíduos idosos, foram apontados.

Chronic pain in the elderly: a continuing education program for certified nursing assistants

One of the greatest challenges facing nursing today is the provision of proper pain management in patients suffering from both acute and chronic pain. The purpose of this article is to provide an introduction to a continuing education program for use by registered nurse instructors in teaching certified nursing assistants (CNAs) about their role in the management of pain in elderly persons. The article includes a summary of the program content.