Fundamentals of Nursing Q 589
Pain tolerance in an elderly patient with cancer would:
A. Stay the same.
B. Be lowered.
C. Be increased.
D. No effect on pain tolerance.
Correct Answer: B. Be lowered.
There is potential for a lowered pain tolerance to exist with diminished adaptive capacity. For older patients with cancer, unrelieved pain can affect functioning, increase cognitive impairment, and depression, which in turn can influence the severity of pain and make management more challenging. In sum, the literature indicates that cancer pain in advanced disease is multifaceted and can adversely affect the lives of patients and their caregivers. Changes associated with aging have the potential to further impact this experience.
Option A: Pain continues to be a common and distressing symptom, despite pain management being a central focus of palliative care and guidelines for the management of cancer pain. Estimates suggest that as many as 60% to 80% of individuals with recurrent or metastatic cancer experience pain. Among older patients, cancer pain, similar to other types of pain, tends to go unrecognized and undertreated
Option C: In older individuals, the higher incidence of comorbidities, age-related declines in functioning, and associated symptoms can further complicate cancer pain and its management. Adding to the complexity is the recognition that the experience of pain is not merely a sensory event, but is multifaceted, comprising sensory, affective, and evaluative components.
Option D: Indeed, the belief that pain can emanate from both physical sources and nonphysical sources (psychological, spiritual, and interpersonal) is central to the concept of total pain, put forth by Dame Cicely Saunders, founder of the modern hospice. This nonphysical source of pain derives from feelings of helplessness, being dependent on others, and having difficulty in reshaping relationships, and has been described by terminally ill older patients as creating the worst suffering.