Dixie Olson

Date of Award


Document Type

Independent Study

Degree Name

Master of Science (MS)


Pain in the elderly often goes unrecognized until the pain is critical and difficult to manage. Insufficient pain management increases morbidity, mortality, and it can lead to multiple aggravating circumstances which may impede recovery from total hip arthroplasty (THA) or total knee arthroplasty (TKA). These adverse conditions and circumstances include: poor quality of life, physiological and psychological problems, anxiety, depression, sleep deprivation, nausea, vomiting, delirium, falls, urinary retention, constipation, dysesthetic itching, extended recovery time due to patients guarding affected limb and/or complications from inactivity such as pneumonia, deep vein thrombosis (DVT) and pulmonary embolism (PE). Slower recovery may lead to physical disabilities and chronic pain, not to mention the increased expense for extended stays and re-admissions to the hospital for compiications. Review of literature indicates the geriatric patient needs adequate pain management including scheduled pain medications in the first few weeks post-operatively, including narcotic and non-narcotic analgesics depending on the patients' comorbidities. Nurses must take the time to find out what methods the patient has used to relieve pain in the past and incorporate them. Physicians and nurse practitioners need to be aware of pain guidelines and pathways for various comorbid conditions, and utilize them for the benefit of patient recovery time and also to help prevent post surgical chronic pain which debilitates and adds to the lifetime cost of patient healthcare. Managing the side effects of narcotic administration is a small problem in comparison to the huge cost to the patient and society for under treating post operative pain