Table 1.

Sources of Pain in Frail Elders

Pathological		Procedural	Adverse Incidents	Trauma & Basic Needs
Persistent (i.e., chronic) pain Cardiovascular conditions (e.g., stroke, myocardial infarction) Peripheral vascular disease Chronic obstructive pulmonary disease and asthma Diabetic neuropathy and ulcers Shingles and post-herpetic neuropathy	Trigeminal neuralgia Cancer Arthritis Gout Bunions Chronic low back pain Osteoporosis, spontaneous fractures, and spinal stenosis Pneumonia and influenza UTI GERD	Post-operative pain Pressure pain from blood pressure cuff Range of motion and rehabilitative activities Catheter insertion Injections, Intravenous insertions/blood draws, and blood glucose sticks Wound care Pain with ADLs, turning, & transferring Oral care	Fixed positioning on pressure points/ prolonged immobility Contractures Pressure ulcers Skin tears Incontinence rashes Poorly fitting dentures Drug-induced neuropathies Taut restraints	Physical elder abuse Falls (bruises, fractures, sprains/strains, concussions) Depression Anxiety Unmet basic needs (toileting, hunger, breathing, sleep) Labored breathing at end-of-life