Pain Management in Advanced Cancer Care Among the Aged (Essay Sample)

Pain Management in Advanced Cancer Care Among the Aged Student's Name Institutional Affiliation Course Name/Code Professor's Name DueDate Pain Management in Advanced Cancer Care Among the Aged Geriatrics are more prone to cancer and its complications than the younger population. Pain is a significant complication of advanced cancer. Pain often goes inadequately managed in the geriatric population. Patients long ago used to die in so much pain due to under-management. Pioneers such as Dame Cecily Saunders have been instrumental in advocating for effective pain management in the elderly. The world health organization developed the WHO pain ladder that has been used in the management of pain. This paper addresses the prevalence of pain in advanced cancer patients and current practice in managing pain, and recommendations from research articles regarding pain management in geriatrics. It shall also encompass the role of a nurse in pain management in advanced cancer and According to Bouhassira, Luporsi, and Krakowski (2017), over 80% of patients with advanced cancer presents with severe pain. Another study claims that advanced cancer is a significant condition in nursing homes (Siegel, Bakerjian & Zysberg, 2018). It is also associated with patient health outcomes. Advanced cancer is incurable, and therapy is palliative; it aims to slow down cancer progression and manage pain. Most of the cancerous tissues have metastasized, and others have formed malignant/fungating words. The tumors shall have exponentially grown and exerted much pressure on the nerve endings. This is the primary cause of excruciating pain. The condition being palliative, the patients suffer much psychological trauma. Management of pain in advanced cancer thus utilizes pharmacological and also non-pharmacological methods of pain management are essential (Hunnicutt, Tjia, & Lapane, 2017). The WHO Pain Ladder states that there are three levels of pain management depending on the pain severity. Severity depends on the patient's self-report and the nurses' pain assessment (Hunnicutt et al., 2017). Pain is rated as mild, moderate, or severe and management therapy is dependent on the level. Several pain assessment tools have been developed to assist the healthcare providers' rate and manage pain among geriatrics. Non-pharmacological methods of cancer pain management, such as radiological interventions, have proven very useful. They minimize pain, slow down disease progression, and promote the healing of wounds common in advanced cancer. In addition, psychotherapy serves to distract the patient and manage psychological, spiritual, and emotional pain. Articles Addressing Pain Management In Advanced Cancer Among The Geriatrics Lichtman, A. H., Lux, E. A., McQuade, R., Rossetti, S., Sanchez, R., Sun, Wright, S., Kornyeyeva, E., & Fallon, M. T. (2018). Results of a double-blind, randomized, placebo-controlled study of nabiximols oromucosal spray as adjunctive therapy in advanced cancer patients with chronic uncontrolled pain. Journal of Pain and symptom management, 55(2), 179-188. Lichtman et al. (2017) studies the effectiveness of Nabiximols Oromucosal Spray as an adjunct therapy in patients with advanced pain unresponsive to optimized opioid therapy. First, the article reviews the optimal therapy. As seen earlier from the WHO ladder, opioids are extensively utilized at all WHO pain management ladder levels. Opioids are the most effective drugs in managing pain in cancer patients. However, tolerance is a significant problem with opioid analgesics. Therefore, doses become less valuable, and raising these doses could lead to increased undesirable effects of opioid analgesics. The study aimed at finding the effectiveness of Nabiximols in these patients who have developed tolerance to opioids or who do not respond to opioid analgesics. Nabiximols are studied as an adjunct, as a drug used in conjunction with primary therapies to enhance their effectiveness. The study claim that "Nabiximols might have utility in patients with advanced cancer who receive a lower opioid dose" (Lichtman et al., 2017). The drug is not superior to a placebo, but its effectiveness among US citizens in several instances has been statistically proven. Therefore, it can alleviate suffering in advanced cancer among geriatrics who develop severe pain in cancer. Brant, J. M. (2018). Assessment and management of cancer pain in older adults: strategies for success. Asia-Pacific Journal Of Oncology Nursing, 5(3), 248. Brant (2018) addresses success strategies for assessing and managing cancer pain in older adults. Pain management in older adults is quite challenging. The aged have many physiological and psychological changes secondary to aging. The notion that pain is a normal part of aging complicated further, as pain is easily neglected. Thus, they present with more severe complications of cancer and thus require special pain assessment and subsequent management of pain. As mentioned earlier, the geriatric population is quite prone to the development of cancers and their complications. Thus, pain is a common occurrence among geriatrics with cancer and advanced cancer. The article suggests individualized pain assessment. It also advocates for assessing how the physiological, emotional, and spiritual domains are affected by pain. The article proposes a five-step approach for assessing pain in cancer patients. Gold Standard for Pain Management Pain assessment gold-standard is self-report of pain which involves the verbal reports of pain. The second domain, pathology, set to determine the advent of pain and possible severity associated with various types of cancer. Assesses patient behaviors that show pain. Facial expressions are the gold standard in the behaviors domain. The primary caregiver also acts as a source of information. They report on recent changes in their loved ones that indicate pain. If present measures suggest pain, the next step is performing an analgesic trial. Opioids are often preferred in cancer pain, especially in advanced cancer pain. However, an analgesic trial helps patients who are unresponsive to opioid therapy. The study by Brant (2018) suggests that pain management should be done considering the physiological changes associated with aging. Renal compromise, cardiovascular conditions, and gastrointestinal malabsorption are considered. For example, morphine is the most widely used opioid in the management of cancer pain. However, morphine has two active metabolites that cause renal compromise, which could be fatal in patients with preexisting renal conditions. NSAIDs should be used with caution due to their potential toxicities, including gastrointestinal problems. Opioids such as morphine, fentanyl, hydromorphone, oxycodone, and methadone are used in cancer pain management (Lichtman et al., 2018). They should be used with caution due to their adverse effects, majorly constipation. Co-analgesics adjuncts such as the one discussed earlier (Nabiximols) help increase analgesic efficacy, avoid adverse analgesic effects and reduce the dosages of analgesics used. Many nursing ethical issues face advanced cancer pain management. Cancer pain management involves the extensive use of opioids. However, they are associated with adverse effects, toxicity, and tolerance. Increasing doses to manage pain increases the chances of toxicity and the development of adverse effects. Other methods of pain should come in handy in such situations. Pain management should involve adjuncts, pharmacological and non-pharmacological methods of pain management. Importance of Nursing in Quality Improvement Nursing as a profession is critical in enhancing quality patient care. Nurses act as links between doctors and patients and spent more time with the patients than any other healthcare professional (Siegel et al., 2018). They can access and manage pain in the patients all th...