Older people in hospital - Pain management

Pain can affect all areas of your life: your mood, your sleep, and your ability to move around and to think clearly. While many people will experience pain in hospital as a result of their condition or during recovery from treatment such as surgery, this pain needs to be managed. Controlling pain helps your recovery and there are many things you can do.

Don’t consider pain to be a part of life that you have to adjust to, or as a normal part of ageing.

Pain is often categorised as acute pain, which has an identified cause and should cease once the cause has healed, or chronic pain, which lasts well beyond the period of healing. If you have pain, talk to your nurse and doctor so that they can treat the cause of it and treat the pain itself.

What is pain?

Every person’s experience of pain is different. Pain can be associated with a physical injury, but it can also be an emotional response. Talking about your pain and how you are feeling is very important. Some people think that they just have to accept pain and that talking about it won’t help. But there are ways of managing pain if you tell your healthcare team about it.

Pain does not feel the same for everyone. Describing your pain clearly will help hospital staff find the best treatment.

A person may describe pain by:

• how strong pain feels (such as dull or intense)
• the nature of the pain (such as an aching feeling or a sharp pain)
• by location (where you feel the pain in your body)
• an emotional response (such as unpleasantness, fear, exhaustion, frustration or anxiety)
• its impact on aspects of daily life (such as getting dressed, mood disturbance, social relationships and leisure activities).

Acute pain is pain that lasts for a short time (such as days or weeks). It is common following surgery or physical trauma such as damage to skin or muscles tissues. Acute pain usually goes away after the damaged area is healed.

Persistent or chronic pain is pain that extends beyond a normal healing period (traditionally beyond three months). It can exist without a clear reason at all, for example with a condition where healing is not expected to occur. Chronic pain is recognised as a condition in its own right, not just a symptom.

Identifying the underlying cause of a person’s pain while they are in hospital is important so that staff can treat and manage that pain effectively. Treatment will vary according to the type of pain, but will involve a combination of medication and other approaches.

Pain management while in hospital

People in hospital may experience discomfort or acute pain as a result of surgery or some procedures. Always report pain to hospital staff because it can be managed during your stay and addressed as part of your discharge plan.

Some people are reluctant to acknowledge and report pain, but pain that is not managed can slow your recovery and lengthen your stay in hospital. Unmanaged pain can also mean you become less mobile and less independent. Uncontrolled pain can make you more likely to become depressed, anxious or isolated from others. It can also make it harder to do everyday activities.

You can help hospital staff to manage your pain

You don’t have to put up with acute pain during your time in hospital, so make sure you speak up and tell staff about how you are feeling.

The most accurate information about your pain comes from you. Tell hospital staff if you feel any pain and:

• where the pain is
• how strong the pain is
• the type of pain you have (for example, aching, throbbing, stabbing)
• the activities that make the pain better or worse
• how the pain affects your daily activities (for example, your appetite, sleep, mood, ability to move around).

If you are in pain, ask for pain relief as soon as it starts. It is better to have pain medication regularly than to wait for the pain to get bad.

Hospital staff may often ask you if you are in pain or do a formal pain assessment. Answer the questions honestly and to the best of your ability.

Ask your nurse for pain medication half an hour before any activity that you know will make your pain worse.

Techniques to manage pain in hospital

Ask staff for information on ways to help reduce pain. You, your family and carers should take an active role in planning your treatment and setting goals.

Treatments for pain usually include both medication and other therapies, such as:

• gentle exercise
• applying heat or cold packs
• manual therapies (for example, physiotherapy or massage)
• relaxation.

Try and find enjoyable activities that don’t worsen your pain and that help to take your mind off it. Stay as mobile as you can. Resting in bed for long periods will increase pain and put pressure on your skin. You will also lose muscle strength and become less mobile over time.

Pain relief after you leave hospital

If you are prescribed pain-relieving medication to take after leaving hospital, be aware that there are some common side effects, which can include:

• reduced alertness
• constipation.

Ask your doctor about the medication you have been given, what side effects you may experience and what you need to do if you experience any of these side effects. You can also ask your doctor for the Consumer Medicine Information sheet, which provides detailed information about the medication you are talking.

You can also search for Consumer Medicine Information sheets on the healthdirect website.

Where to get help

• Your GP (doctor)
• Allied health staff
• Patient liaison officer
• Nursing staff