11 November 2021

People living in pain face a multitude of complex barriers and unique challenges. These challenges often increase as we get older. It is common for people, as they age, to feel that they are listened to less often and their opinion is held less highly by those around them.

This is especially true when it comes to pain. Many older people and their carers believe that pain is a normal part of ageing and there is little potential for improvement. No-one wants to be seen as someone who complains too much. Asking for help is not always easy, especially if you are seeking “not to be a bother because pain is just a part of getting older.”

Australia has an ageing population— the Australian Bureau of Statistics projects that by 2050, around one quarter of all Australians will be aged 65 years and over, with the proportion of younger Australians declining. In fact, the number of people aged 65 years and over will overtake the number of children aged 0 to 14 years by around 2025.

Effective pain management for older patients is an issue that is in the interest of every Australian. Chronic pain is a common condition among older Australians - one in three people aged over 65 are living with chronic pain - and effective pain management should be a core responsibility of all health and aged care providers.

Unfortunately, evidence suggests many older people with pain are poorly treated or under-treated.

In some cases, when an older person has a chronic pain condition that does not meet a health professional’s expectations of what constitutes an illness, it is attributed to “old age” and not given further investigation.

While medical practitioners should generally base the way they choose to treat a patient on the patients’ condition, not on their age, this is often not the case.

A study conducted in the Netherlands found a correlation between nurses’ attitudes toward older patients and the quality of communication and care provided to them[1]. The more negative the nurses’ attitudes, the shorter, more superficial, and more task-oriented their conversations with older patients were. The nurses with less positive attitudes to ageing tended to speak to older patients in a patronising tone and did not involve them in consultations or decisions.

Painaustralia was recently told about the experience of an older woman who had a hip replacement. While in hospital she was having difficulties getting her pain medication when she needed it and yet younger patients in the same ward were afforded more timely pain relief. Her comment was “I have white hair, they don’t listen to me”. Whether or not this was the case, or the staff were just really busy, her perception was that her age was having an impact on her care.

Up to 80 percent of people in residential aged care have persistent pain, and evidence suggests pain is often under-treated in older people. Getting older is not a reason to accept living with chronic pain. Regardless of age, older people should play an active part in their medical care and be consulted and given every opportunity to make informed decisions about their own treatment.

Untreated or poorly treated chronic pain can perpetuate the pain condition and severely reduce function and quality of life. It impacts personal relationships and can have profound emotional and psychological ramifications.

Older Australians need greater confidence to seek out best practice pain treatment and be active participants in their remedial journey as well as building resilience in managing chronic pain. This cannot happen until we all accept that living with pain is not just a normal part of ageing and that older patients in pain should be heard and listened to by the people who are providing their care.

The Royal Commission into Aged Care has brought sharp focus to many issues of neglect and lack of appropriate care of older Australians. The significance of pain among older people should be one of these issues – at the very least it provides a key indicator of appropriate care. If we fail to properly manage pain because it’s considered a ‘symptom’ of older age that doesn’t warrant attention or any intervention, what does that say about our capacity to improve the way we respect and care for our older citizens? 

We should never accept that old age is an automatic punishment, a sentence to live in pain. Our medicine is better than that, and surely we are better than that.

Carol Bennett, CEO

Have you or someone you loved experienced ageism relating to your pain? Tell us your story at Painaustralia’s survey here.