November 2006, Volume 36 Number 11 , p 20 - 21
KELLY, ANNE MARIE RN,C, CHPN,BC, BSN
QUESTION: My 82-year-old patient has osteoarthritis (OA) of the hands and knees, and her functional ability has declined significantly from the pain. How can I help her manage her pain and improve her quality of life?
ANSWER: Remember that older adults may underreport pain, leading to inadequate treatment. So perform a thorough pain assessment that addresses the patient's physical, psychosocial, and spiritual needs.
The treatment plan depends largely on the progression of the disease, the patient's disabilities, and the severity of pain. Obtain a complete medical history and perform medication reconciliation and a physical exam with a focus on the patient's musculoskeletal system. Assess her functional ability, including activities of daily living. Obtain a psychological history (with emphasis on anxiety, depression, coping style, and personality traits). Ask her about her goals and expectations for OA treatment. Document all your findings. ...