Pain in the Elderly

The receipts behind Chapter 16

The quietest patient on a nursing-home floor is often the one in the most pain. In Chapter 16 I follow an eighty-four-year-old sedated for agitation who was actually lying on a broken back, show how the chart records half the pain of a person who cannot speak, and why a precise procedure done awake is the conservative option and the pill is the aggressive one.

The book makes the argument. This Deep Dive shows the evidence, claim by claim: the study, who was in it, the number and where it sits in the paper, what it does not show — and the questions to bring to your own physician. It is written to be handed to your doctor.

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Frequently asked questions

How do you know if someone with dementia is in pain?

Do not read quiet as comfortable. Chapter 16 shows that the quietest patient on a nursing-home floor is often the one in the most pain, and that the chart records half the pain of a person who cannot speak. Agitation can be pain, too: the chapter follows an eighty-four-year-old who was sedated for agitation while lying on a broken back.

What is the safest pain treatment for elderly patients?

Chapter 16 turns the usual answer around. A precise procedure done awake is the conservative option, and the pill is the aggressive one. That is Dr. Padda’s position for older patients, and the Deep Dive gives the evidence behind it study by study, with the questions to bring to your parent’s physician before another prescription is added.

What does the Chapter 16 Deep Dive cover?

It is a 51-page briefing with 162 references, every one verified, written by Dr. Gurpreet Singh Padda, MD, MBA, MHP, and Dr. KrisJay Fucanan, MD. It covers why pain in older adults goes unrecorded, what happens when agitation is sedated instead of examined, and why a precise procedure can be the gentler choice. The PDF arrives by email within a few minutes.