| Chronic pain is prevalent in older adults and is often untreated or insufficiently well managed. Pain in the elderly leads to significantly reduced quality of life and may be a major factor in loss of independence. Research has shown that due to a variety of concerns, physicians are often hesitant to prescribe pain medications for the elderly, and that older adults are often reluctant to utilize pain medications even when they are prescribed. Compounding the problem is the fact that older adults often employ highly risk-averse emotional heuristics in the decision to use pain medications. This dissertation explores those heuristics, in particular, the emotional heuristics, utilized by older adults when considering whether and how to take their pain medications.;Following an overview of the major issues related to pain management in the elderly, this dissertation presents findings of home interviews with an ethnic and socioeconomically diverse sample of eleven community-dwelling older adults (ages 63 -- 86), all of whom are under a physician's care for pain, regarding their pain experience and their perceptions of their pain medications. After identification of key themes via qualitative data analysis, interview videos were edited to create a 30-minute DVD of participants, highlighting major themes uncovered from the interviews.;Results show that regardless of physician or medication recommendations, the participants each crafted highly individual processes for their pain management and their use of pain medication. Emotional heuristics were very much in use, especially as they related to fears of addiction and experience of past addiction in themselves and loved ones. Most participants were also active consumers of written, broadcast or internet information on pain medications, their side effects and their risks. A key determinant of strategy was socioeconomic status, which determined the kinds of complementary interventions that were possible and utilized. This dissertation closes with reflections on how older adults manage their chronic pain, implications for intervention, concluding remarks and suggestions for further research. |
