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Gender matters for pain management in aged care

Differences in male and female experiences of illness and pain may not be sufficiently understood in treatment of aged care residents, according to a new review.

Catholic Health Australia’s health policy officer Emma Hoban has analysed differences in how men and women experience illness and pain.

“Gender disparities in the experience of pain have particular implications in an aged care setting where women live longer, experience more chronic disease and on average spend a greater length of time,” Ms Hoban told Australian Ageing Agenda.

“Members of the aged care workforce need to understand the difference in how men and women experience and express pain to ensure that they are able to provide high quality care that meets the individual needs of residents,” she said.

“In an aged care setting where residents sometimes take a variety of medications, it is important to recognise and understand that men and women can respond to medications differently to aid prescription and maximise the comfort of residents.”

Ms Hoban’s review of the implications of gender disparities in Australian health care was published in the spring edition of Catholic Health Australia’s Health Matters.

An international study of 85,052 participants across 17 countries found that 45 per cent of women had a chronic pain condition compared to 31 per cent of men, Ms Hoban said.

“Evidence suggests that women are more sensitive to and less tolerant of pain, and are more likely to experience and report pain-related conditions such as musculoskeletal conditions, bone disorders or headaches,” she wrote.

“Perceptions of woman’s heightened pain tolerance by some healthcare professionals has meant that women are less likely to have their pain believed and treated and are often accused of being hypochondriacal and anxious.”

She said medical professionals relied on objective, visible, biological and physical symptoms of illness and could be dismissive of subjective feeling and the psychological component of illness.

“This seems to be to the detriment of women, who due to the nature of biological structure are more likely to experience internal, non-visible pain, such as period pain, and are more emotive in the way they express pain.”

Ms Hoban said pain associated disorders would become more prevalent in Australian society as the population aged.

“Understanding gender disparities in the experience and treatment of pain will be a key component to ensuring all Australians experience evidence based quality care that facilitates positive outcomes.”

Elizabeth Carrigan

Australian Pain Management Association CEO Elizabeth Carrigan supports Ms Hoban’s views.

“All of the care teams in each facility need training in pain management to identify, assess and follow up suspected pain,” she told AAA.

She said APMA had heard myths – such as people with dementia don’t suffer as much pain, which were unhelpful viewpoints for staff expected to be managing pain.

“Pain management in aged care settings should include pain management plans for each resident so that there are established practices which involve medical as well as physical and emotional strategies to manage the pain and maintain quality of life and enjoyment.”

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2 Responses to Gender matters for pain management in aged care

  1. Robyn Youl November 25, 2017 at 3:59 am #

    Pain Management is not innate or intuitive. It is an acquired skill that needs to be taught. I have been fortunate indeed to have been a student of the Barbara Walker Pain Management Program. At 72 with severe scoliosis/rheumatoid & osteo arthritis I lead an active life as a circus manager of 2 Papillons who visit 3 aged care facilities each week.
    If those of us who have been taught Pain Management could be skilled to enable us to share what we have learned with residents it may help.
    I learned as an individual and in the marvellous courses BWPM Program runs.
    Do not use any pain medication – mindfulness – even basic breathing skills help.

  2. Ruth December 6, 2017 at 11:49 am #

    Yes Robyn Youl. One of the things that frustrates me is the lack of training for health professionals in chronic pain, the lack of referrals to psychologists and support groups to start early interventions, and the lack of referrals to tertiary pain clinics. There is much more to be done.

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