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American Journal of Hospice and Palliative Medicine®
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Holistic Assessment of Chronic Pain Among Elders

Susan Ruzicka, RN, PhD

University of Texas Health Science Center School of Nursing, ruzicka@ swbell.net, GRECC South Texas Veterans Health Care Center, San Antonio, Texas

Sandra Sanchez-Reilly, MD

School of Medicine, GRECC South Texas Veterans Health Care Center, San Antonio, Texas

Meghan Gerety, MD

Department of Internal Medicine, School of Medicine, University of New Mexico Health Sciences Center, and New Mexico Veterans Affairs Health Care System, Albuquerque, New Mexico

This pilot study assessed pain using 7 dimensions of pain (physiologic, behavioral, sensory, affective, cognitive, sociocultural, and spiritual) to better understand and identify patterns of elder response to chronic pain within a holistic framework. Previously validated instruments were used to assess 150 cognitively intact subjects, aged 65 years and older, with chronic pain. Thirteen patterns were identified reflecting distinct patterns of pain response. Two patterns comprised 85% of the responses: (1) high spiritual well-being, low physiologic pain, and high perceived independent functioning; and (2) high spiritual well-being, low physiologic pain, and lower perceived independent functioning. The 11 other patterns of pain response also varied in their responses to the pain experience. These responses reflect the unique and holistic experience of chronic pain among older adults. Holistic assessment enhances the understanding of the pain specific to the individual. Self-perceived functional dependence and the spiritual component significantly influence chronic pain experiences.

Key Words: holistic assessment • chronic pain • functional assessment • spiritual assessment • aging

American Journal of Hospice and Palliative Medicine®, Vol. 24, No. 4, 291-299 (2007)
DOI: 10.1177/1049909106299061
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