Shortly before the holidays, I had the privilege of speaking with geropsychiatrist and researcher Dr. Stephen Thielke, a recipient of the Paul B. Beeson Award, which is funded in part by the John A. Hartford Foundation. I was excited to hear about the work that he and his colleagues are doing to dispel myths and stereotypes about pain and aging. Among them are the notions that pain is a natural part of getting older, that pain inevitably gets worse once it is present, that people who tough it out become accustomed to pain, and that pain medications are highly addictive. While it all sounds innocuous, this conventional wisdom limits the choice of treatment and the care that older adults receive and ultimately sets boundaries on their quality of life. So it’s important to get the word out that the real evidence, in fact, encourages optimism. More on that shortly.
But first, a few words of introduction. As I learned, there’s a nexus of connections at the heart of this work with links to the Hartford Foundation. Indeed, a significant part of what we do at the Foundation is to bring thought leaders together. As some of our readers may know, Dr. Thielke is an Assistant Professor in the University of Washington’s Department of Psychiatry and Behavioral Sciences, and he is also the Associate Director for Education at the GRECC of the Seattle Puget Sound Veteran’s Administration. Early in his career, Dr. Thielke received a Hartford-funded professional development award for aspiring young scholars devoted to geriatric health outcomes research. It was during this time that he met Dr. Cary Reid, a fellow Beeson alumnus and the Director of the Hartford Center of Excellence in Geriatrics at Weill Cornell. Dr. Reid’s mentorship enabled him to develop a research program on the effects of chronic pain on quality of life among older adults. Along with Dr. Joanna Sale, a researcher from the University of Toronto, they began to explore the stereotypes that older adults have about chronic pain and its treatments. Together, they discovered that myths and misconceptions about pain are common, and that they influence how people live with and manage their pain. (For queries, contact Dr. Thielke here.) Identifying and addressing such stereotypes is one of the key unmet needs in pain management.
So what’s the real evidence, and how is it important to patients and providers? While more research needs to be done around the factors that influence pain outcomes, initial research shows that pain doesn’t occur more often in older adults, that it is more transitory than we think, that toughing it out is not the best approach, and that the medications used to treat pain are not highly addictive in general. These findings highlight the benefits of appropriate treatment. The bottom line is that patients shouldn’t give up. They should work with their providers to identify what works best for them, and that can mean physical activity in addition to pills.
Getting this message out to providers is crucial. According to Dr. Thielke, four out of every five older adults who have pain say that prognosis is extremely important not just for the sake of planning but for the comfort of knowing. However, fewer than one in four get any real, useful information.
At the same time, providers need to stay abreast of the latest drug and treatment approaches and pain management strategies. On this front, our readers will be glad to know that the American Geriatrics Society, a Hartford grantee, recently updated and issued clinical practice guidelines for the management of chronic pain with a special focus on the use of new pharmacologic therapies. For more information, click here. There’s even a handy pocketcard for providers and a tip sheet for patients.
Thanks to the combination of these efforts in research and practice, older adults both today and tomorrow can enjoy a higher quality of life.