Most vulnerable being denied rights, say pain experts
Thursday December 10, 2009
Thousands of older Australians are being denied fundamental human rights because their pain
is not being effectively treated, world-renowned pain expert, Professor Michael Cousins, said
today.
“For too long, older people experiencing chronic pain have been dismissed and told that pain
is just part of getting old and that nothing can be done,” said Professor Cousins, who is Chair
of the National Pain Summit steering committee and director of the Pain Management
Research Institute (PMRI).
“This is not true. Chronic pain can be effectively managed in older people so that they can
continue to lead fulfilling personal, family, work and community lives.”
More than 20% of people aged over 65 report persistent pain, with more than half of them
saying it severely impacts on their quality of life, according to the findings of the MBF
Foundation’s landmark report, The High Price of Pain produced by Access Economics using PMRI
economic data.
The report shows that pain prevalence increases with age – for example, over 30% of females
in the 80 – 84 year-old group report chronic pain.
“Persistent pain is experienced by 50%-80% of people in residential care but much of this is
under-reported, under-recognised and under-treated,” said Professor Cousins.
Improving pain management in older people has in recent days been incorporated into the
National Pain Strategy which will be finalised at the summit being held at Parliament House,
Canberra on March 11, 2010. The aim of the summit is to have pain management addressed
as part of the Rudd Government’s national health reforms.
The summit, being led by the Australian and New Zealand College of Anaesthetists, Faculty
of Pain Medicine, the Australian Pain Society and Chronic Pain Australia in collaboration
with inaugural supporters’ MBF Foundation and PMRI will bring together an unprecedented
gathering of over 200 leading authorities in pain medicine, other health professionals and
representatives of consumer and industry bodies.
University of Sydney Professor Cousins said almost all of the wide range of treatments now
used for pain in younger people work for older people – whether the pain is acute (e.g. after
surgery or trauma), chronic (e.g. back pain, post-shingles or associated with diabetes, poststroke etc) or cancer pain.
“Chronic pain and cancer pain are among the most common reasons that older people lose
their ability to live independently,” Professor Cousins said.
“This means some of our most vulnerable people suffer a severe erosion of their quality of
life. When older people can no longer make decisions about their lives they are being
deprived of their human rights.”
Professor Cousins said it was unacceptable to deny pain management to older people as is
often the case today because of the many barriers in their way. Some of these included:
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Myths and misconceptions about the causes of pain.
Lack of knowledge and training in health professionals.
Lack of access to pain medicine specialists due to loss of mobility, lack of family or
friends to provide support or advocacy, and due to age-related exclusion criteria in
some pain clinics.
Other health problems and/or dementia may limit pain management options.
Dementia is a significant challenge for pain assessment and treatment. “Difficulties
communicating pain does not mean pain is absent,” Professor Cousins said.
He said geographical factors (remote, rural or residential locations) and chronological age
should not limit access to pain management.
“At 85, remaining life expectancy is still an average, six-seven years – plenty of time to
benefit from effective pain management,” Professor Cousins said.
The scale, impact and cost of chronic pain, estimated at $34.4 billion per year in Australia, is
so alarming that it should be a national health priority, said Dr Christine Bennett, the former
Chair of the National Health and Hospitals Reform Commission, and MBF Foundation
Steering Committee Chair and Chief Medical Officer, Bupa Australia.
“One of the key recommendations made by the Commission was to connect and integrate
health and aged care services so that the needs of people living with chronic diseases, such as
chronic pain, and the elderly can be better met,” said Dr Bennett.
The Dean of the Faculty of Pain Medicine, Dr Penelope Briscoe said older people were often
only offered weak analgesic drugs but even these may cause serious side effects.
“It is essential that a multidisciplinary team assesses and treats all the factors that may be
contributing to pain and suffering, such as loss of independence, loss of family and friends
and depression,” Dr Briscoe said.
The President of the Australian Pain Society, Professor Stephen Gibson, who is also the
Deputy Director of the National Aging Research Institute in Melbourne, said: “The Australian
Pain Society recently released guidelines for the management of pain in residential aged care
facilities and these have been distributed to all 3300 aged care facilities in Australia.
“The challenge now remains to implement such guidelines into better practice for older
people suffering from bothersome pain.”
The President of Chronic Pain Australia, Ms Coralie Wales said: “Older people who have
difficulty accessing clinics and hospitals need to be able to access help in their own
communities.
“The summit recommends better training for health professionals in community settings, and
also greater community understanding of the right to pain management of all older
Australians.”
Professor Cousins said: “Older people are so often told ‘you’re old, what do you expect?’
This is the sort of attitude the summit hopes to eradicate.”
More information about the National Pain Summit and the latest draft of the National
Pain Strategy can be found at www.painsummit.org.au
To speak to Professor Cousins, please contact National Pain Summit media manager
Clea Hincks on (03) 9093 4917 or 0418 583 276.
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