Mr. Walters is an 85 year old widower who lives alone. He was…

Mr. Walters is an 85 year old widower who lives alone. He was active and had been walking every night except for the last 6 weeks, when his knees began to bother him. He fell last week while trying to get to the bathroom. He hit his elbow, fractured his wrist and bruised his ribs and knees. During your interview, he tells you this is not the first time he has fallen, but it is the first time he has injured himself. For the most part, Mr. Walters is healthy, with the exception of hypertension, enlarged prostate, mild diabetes controlled with oral medications, controlled atrial fibrillation and some osteoarthritis in his knees. In addition to the oral hypoglycemic, Mr. Walters is taking Furosemide 40mg each morning, Lanoxin 0.125 mg daily, enteric-coated aspirin daily, Enalapril 25 mg twice daily, gingko biloba, Panax Ginseng, capsaicin to his knees and back and glucosamine twice daily. Mr. Walters states the pain is terrible and nothing seems to help. He rates his pain at a 10, on a scale of 0-10. Mr. Walters states “You don’t believe me.” In addition, he reports with movement the pain feels like a knife is stabbing him. He reports his knees have been acting up recently along with some numbness in his feet that seems to be worse at night. The doctor gave him some pills, but he states “I’m afraid to take them because I don’t want to get hooked on drugs.” He also reports not sleeping well.

 

1). What kind of pain does does Mr. Walters have? Does he have more than one?

2). Why is Mr. Walters new pain so severe? Is there anything in his current condition that would give an indication of why the pain intensity is so high?

  3). How have Mr. Walters co-morbidities affected his current pain complaint?

4). How is has his pain affected his ability to function? What recommendations would you make?

5. Discuss three reasons pain management is an important part of patient care in the elderly.

6. Discuss the reasons pain can be more difficult to manage in the elderly population.

Explanation & Answer

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