Pain in Older Adults with Intellectual Disabilities
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People with intellectual disabilities (ID) have both intellectual and adaptive deficits resulting from genetic or medical disorders. Although scientific and clinical awareness has emerged that atypical pain responses in ID do not necessarily reflect pain insensitivity or indifference, pain assessment is still hampered by the risk of incorrect interpretations. Older adults with ID form a complex subgroup, because challenges in pain management from general older adult care and care for people with ID are combined. An increasing life expectancy demands an expertise in palliative care for the ID population, with its central concepts of pain treatment, quality of life, and communication difficulties. Although some categories of behavior appear sensitive for pain in adults with ID and pain diagnostic instruments have been developed, an individual approach is needed due to the many factors that influence pain in the ID population. This includes a tailor-made pain management plan with pharmacological and non-pharmacological interventions targeted at the pain characteristics of the specific individual in context of medical and psycho-social co-morbidities.
KeywordsIntellectual disabilities Misconceptions Atypical pain behavior Communication difficulties Individual pain profiles Pain management plan Polypharmacy Analgesic failure
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