Pain is both a sensory and an emotional experience. In a multidisciplinary pain management clinic for a geriatric population, pain and mood have been assessed prior to the initiation of management in 49 of 100 referred patients. Patients... more
Pain is both a sensory and an emotional experience. In a multidisciplinary pain management clinic for a geriatric population, pain and mood have been assessed prior to the initiation of management in 49 of 100 referred patients. Patients have been assessed clinically, for psychological disability using the profile of mood states (POMS) and a visual analogue scale for mood, for pain using the McGill pain questionnaire (short form), word descriptor scale and visual analogue scale and for activities of daily living (ADL) using the Disability and Impairment Interview Schedule and the Rapid Disability Rating Scale -2. All testing has followed initial screening to exclude dementia. For the group assessed by psychometric measures, median age was 75 years (range 56 to 91); 41 were female. Major pathologies were degenerative musculoskeletal disease (15), post-herpetic neuralgia (9), and psychiatric conditions (7). Intra-test item correlations were found to be significant for the McGill quest...
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Objective Multidisciplinary pain clinics have an established role in the management of persistent pain, but there is little evidence to support this approach in an older population. This study describes the characteristics and pain... more
Objective Multidisciplinary pain clinics have an established role in the management of persistent pain, but there is little evidence to support this approach in an older population. This study describes the characteristics and pain outcomes of patients attending a pain clinic designed exclusively for older people. Methods A retrospective audit was performed of outcomes of the Pain Clinic for Older People (PCOP) in 2015–2019. Response to treatment was determined by change in Brief Pain Inventory (BPI) scores at initial attendance and after a treatment program. Clinically meaningful improvement was defined by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) consensus criteria of ≥30% improvement in average pain and one-point improvement in pain interference. Results were compared with the national benchmark collated by the electronic Persistent Pain Outcomes Collaboration (ePPOC), which reports the combined results from 67 participating Australi...
Research Interests:
The principles of chronic pain management in the elderly are the same as in younger people; whenever possible, the cause of the pain should be identified and eradicated. However, older people are more likely to suffer pain from incurable... more
The principles of chronic pain management in the elderly are the same as in younger people; whenever possible, the cause of the pain should be identified and eradicated. However, older people are more likely to suffer pain from incurable conditions, and the emotional component of the suffering may be considerable. Treatment options include analgesics, opiates, antidepressants and anticonvulsants as well as psychological strategies, physical strategies such as exercise and transcutaneous electrical nerve stimulation (TENS), and surgery. Improvement of function may be a more important treatment goal than relief of pain.
Research Interests:
Research Interests:
CHAPTER 24 Innovative responses to a changing health care environment Rhonda Nay, Benny Katz, David Le Couteur and Michael Murray FRAMEWORK ... time during their hospitalisation, and as many as 73.5% of postoperative patients and in... more
CHAPTER 24 Innovative responses to a changing health care environment Rhonda Nay, Benny Katz, David Le Couteur and Michael Murray FRAMEWORK ... time during their hospitalisation, and as many as 73.5% of postoperative patients and in intensive care units (Dyer et al ...
Research Interests:
Research Interests:
Research Interests:
To describe the use of acute resuscitation plans (ARPs) among patients on a subacute geriatric ward and to identify factors associated with use of ARPs in these patients.
Research Interests:
Inappropriate use of pain medication has serious consequences for older populations. Experts in the field have noted an increase in opioid prescriptions, and opioid-related hospitalisations and deaths among this vulnerable population. In... more
Inappropriate use of pain medication has serious consequences for older populations. Experts in the field have noted an increase in opioid prescriptions, and opioid-related hospitalisations and deaths among this vulnerable population. In the pursuit of educating pharmacists, physicians, allied healthcare professionals, researchers, academics and the public facing the challenges of chronic pain medication management, 'The Inaugural Monash University School of Public Health and Preventive Medicine (SPHPM) Best Practice in Chronic Pain Medication Management Day Conference' was held in December 2016 at the Alfred Medical Research and Education Precinct (Melbourne, Australia). Fifteen experts presented on aspects of chronic pain epidemiology and current analgesic use in older Australians, and discussed current practice and associated challenges. Presenters highlighted the dramatic increase in opioid prescribing, development of tolerance and withdrawal symptoms, problems with abus...
Research Interests:
Continuing professional development (CPD) is an obligation for all Australasian geriatricians; however, there are no systematic data regarding Australian and New Zealand geriatricians’ satisfaction with, and preferences for, CPD.
Research Interests:
Research Interests:
Increasing frailty is associated with risk of mortality and functional decline in hospitalized older adults, but there is no consensus on the best screening method for use by non-geriatricians. The objective of this study is to determine... more
Increasing frailty is associated with risk of mortality and functional decline in hospitalized older adults, but there is no consensus on the best screening method for use by non-geriatricians. The objective of this study is to determine whether the clinical frailty scale (CFS) can be used to identify patient baseline frailty status in the acute general medical setting when used by junior medical staff using information obtained on routine clinical assessment. This was a prospective cohort study in an acute general medical unit. All patients aged 65 and over admitted to a general medical unit during August and September 2013 were eligible for the study. CFS score at baseline was documented by a member of the treating medical team. Demographic information and outcomes were obtained from medical records. The primary outcomes were functional decline and death within three months. Frailty was assessed in 95 % of 179 eligible patients. 45 % of patients experienced functional decline and ...
Research Interests:
... Benny Katz GERIATRIC THERAPEUTICS Editors: Michael Woodward, Director, Aged and Residential Care Services, Rohan Elliott, Clinical Pharmacist, Graeme Vernon, Senior Drug Information Pharmacist, Francine Tanner, Clinical Pharmacist,... more
... Benny Katz GERIATRIC THERAPEUTICS Editors: Michael Woodward, Director, Aged and Residential Care Services, Rohan Elliott, Clinical Pharmacist, Graeme Vernon, Senior Drug Information Pharmacist, Francine Tanner, Clinical Pharmacist, Austin Health; Robyn Saunders ...
Research Interests:
In recent years, a phenomenon of "late effects of the Holocaust" has emerged, with impacts on the psychological and physical health of ageing Holocaust survivors. As Holocaust survivors age, they may experience heightened... more
In recent years, a phenomenon of "late effects of the Holocaust" has emerged, with impacts on the psychological and physical health of ageing Holocaust survivors. As Holocaust survivors age, they may experience heightened anxiety around normal processes of ageing, worsened post-traumatic stress disorder with cognitive decline, and fear of the medical system. Holocaust survivors are at increased risk of osteoporosis, cardiometabolic disease due to hypothalamic-pituitary-adrenal axis dysfunction, cancer, and sequelae of Nazi medical experiments. From existing medical literature on this topic, practical principles of management are derived to create a framework for sensitive medical management of Holocaust survivors in Australia. The issues discussed are also relevant to the wider geriatric refugee or prisoner-of-war experience.
Research Interests:
Chronic pain occurs frequently in older people but is rarely considered a problem which warrants specialized attention by physicians or specialists in pain management. However a small proportion of older people with significant... more
Chronic pain occurs frequently in older people but is rarely considered a problem which warrants specialized attention by physicians or specialists in pain management. However a small proportion of older people with significant psychologic and physical disability from pain fail to respond to conservative management strategies. In this article, the authors describe the operations of a successful multidisciplinary pain management center for older people and briefly outline outcomes according to measures of pain, mood, and activity. Other factors that are specific and important to the management of chronic pain in older patients are discussed also. Despite some disadvantages, it is concluded that there is a place for multidisciplinary pain clinics for older people.
Research Interests:
The principles of chronic pain management in the elderly are the same as in younger people; whenever possible, the cause of the pain should be identified and eradicated. However, older people are more likely to suffer pain from incurable... more
The principles of chronic pain management in the elderly are the same as in younger people; whenever possible, the cause of the pain should be identified and eradicated. However, older people are more likely to suffer pain from incurable conditions, and the emotional component of the suffering may be considerable. Treatment options include analgesics, opiates, antidepressants and anticonvulsants as well as psychological strategies, physical strategies such as exercise and transcutaneous electrical nerve stimulation (TENS), and surgery. Improvement of function may be a more important treatment goal than relief of pain.
Research Interests:
ABSTRACT ABSTRACTA multidisciplinary pain management clinic specifically catering for the geriatric population, has been established in Melbourne and an analysis of the first 100 patients is presented. The major pathological problems... more
ABSTRACT ABSTRACTA multidisciplinary pain management clinic specifically catering for the geriatric population, has been established in Melbourne and an analysis of the first 100 patients is presented. The major pathological problems referred to the clinic have been musculoskeletal disease (45) and post-herpetic neuralgia (18). A third major category of patients had no identifiable pathological process to account for their pain. Using a variety of measurement scales at least 50% of patients were considered to benefit from attendance at the clinic. It is considered that a pain clinic for the elderly is of value for a patient group often considered difficult to manage; it combines expertise in treatment of age specific pain syndromes with the holistic approach to the care of the elderly.
Research Interests:
Research Interests:
... me, Mark Bradbeer, Benny Katz, and Stephen J. Gibson National Ageing Research Institute and North West Hospital Pain Management ... Cognitive therapy (Fernandez & Turk, 1989; Malone & Strube, 1988) and cognitive-behavioral... more
... me, Mark Bradbeer, Benny Katz, and Stephen J. Gibson National Ageing Research Institute and North West Hospital Pain Management ... Cognitive therapy (Fernandez & Turk, 1989; Malone & Strube, 1988) and cognitive-behavioral approaches to pain management (Malone & ...
Research Interests:
Page 1. 84 Control of Chronic Pain Robert D. Helme1 and Benny Katz2 1 Barbara Walker Centre for Pain Management, Fitzroy, Victoria, Australia, and 2 Pain Management Clinic for the Elderly, Victoria, Australia INTRODUCTION ...
Research Interests:
Evidence-based medicine has been adopted as a means of achieving optimal medical care and to reduce variations in clinical practice. Randomised controlled trials are considered the highest level of scientific evidence. Older individuals... more
Evidence-based medicine has been adopted as a means of achieving optimal medical care and to reduce variations in clinical practice. Randomised controlled trials are considered the highest level of scientific evidence. Older individuals are either excluded or underrepresented in these studies, and those who are included are often atypical of patients seen in clinical practice. To examine the approach to clinical decision making in frail older persons when there is little or no scientific evidence to guide management. A case study is presented of refractory post herpetic neuralgia in a frail older person. Management plans were developed combining the scientific evidence from the pain literature with the practice known as Comprehensive Geriatric Assessment. The rationale and evidence for clinical decision making is explored. Standard therapies for post herpetic neuralgia had been ineffective or limited by side effects in this patient. By a process of trial and error a combination of treatments was found that improved pain and mood but adversely affected cognition. Adjustment in treatments over time resulted in improved pain, mood, and cognition. The art of medicine is not the antithesis of the scientific approach. The art of medicine involves balancing the scientific evidence with the circumstances and the preferences of the patient. Combining the practices of Pain Medicine and Comprehensive Geriatric Assessment may result in a better outcome. When treating older people, clinicians not only need to take into consideration the severity of pain, but also the impact of pain and its treatment on cognition, mood and functional status.
Research Interests:
... Hospice Care Patients With Advanced Progressive Dementia Ladislav Volicer and Ann Hurley. New York: Springer Publishing Company, 1998, 305 pp., $US 48.95. Benny Katz (1999) International Psychogeriatrics, Volume 11, Issue 03,... more
... Hospice Care Patients With Advanced Progressive Dementia Ladislav Volicer and Ann Hurley. New York: Springer Publishing Company, 1998, 305 pp., $US 48.95. Benny Katz (1999) International Psychogeriatrics, Volume 11, Issue 03, September 1999 pp 334-335 http ...
Research Interests:
Chronic pain is more prevalent in older persons than in young adults. In this review the physiological, pathological, and psychological reasons for altered pain sensibility in older persons are explored and strategies for the management... more
Chronic pain is more prevalent in older persons than in young adults. In this review the physiological, pathological, and psychological reasons for altered pain sensibility in older persons are explored and strategies for the management of pain in older persons described. The evidence suggests that altered physiology of peripheral and central pain mechanisms combine with psychological attitudes, such as stoicism and reluctance to confirm the presence of pain, to raise pain threshold. However, once pain is experienced, older persons describe the same severity, quality, and psychological disturbance as younger persons. There is some evidence to suggest that the complaint of pain in the presence of pathology is reported less often in older persons. On the other hand, the presence of persistent or recurrent clinical pain may have a greater impact on the psychological, social, and physical function of older adults. It is also clear, however, that further empirical studies are required in order to delineate the age-related differences and similarities in the chronic pain experience. Management of chronic pain in the elderly requires meticulous diagnosis of the causal pain mechanisms as well as a holistic approach which gives due regard to psychological and social consequences of pain.
Research Interests:
1. Clin Geriatr Med. 1996 Aug;12(3):563-82. Multidisciplinary pain clinics for older people. Do they have a role? Helme RD, Katz B, Gibson SJ, Bradbeer M, Farrell M, Neufeld M, Corran T. National Ageing Research Institute, Parkville,... more
1. Clin Geriatr Med. 1996 Aug;12(3):563-82. Multidisciplinary pain clinics for older people. Do they have a role? Helme RD, Katz B, Gibson SJ, Bradbeer M, Farrell M, Neufeld M, Corran T. National Ageing Research Institute, Parkville, Australia. ...
Research Interests:
Research Interests: Documentation, Pain, Dementia, Pain Management, Humans, and 15 moreOlder people, Nursing Homes, Hospitalization, Chronic Disease, Female, Male, Diffusion of Innovation, Aged, Geriatric Assessment, Medical Records, Pain Measurement, Homes for the Aged, Cohort Studies, Psychology and Cognitive Sciences, and Medical and Health Sciences
ABSTRACT Objective: To evaluate the impact of two educational techniques on the rate of cognitive screening of patients referred to a hospital aged care service.Method: Audit of documentation of cognitive status in the medical record of... more
ABSTRACT Objective: To evaluate the impact of two educational techniques on the rate of cognitive screening of patients referred to a hospital aged care service.Method: Audit of documentation of cognitive status in the medical record of patients aged 65 years or older referred for aged care consultation in an acute teaching hospital following two interventions: a general education program, and a general education program complemented with a pocket-sized laminated Abbreviated Mental Test card.Results: Cognitive impairment, defined as Abbreviated Mental Test (AMT) score of 7 or less was present in 49.9% of patients referred for geriatric consultation over a four year period. Documentation of cognitive state by the referring unit, within forty-eight hours of admission, using a recognised mental status screening instrument was initially 9.4%. Following an education program, documentation of cognitive screening increased to 18.1%, with a further improvement to 28.2% occurring when the education program was supported with a memory aid, a laminated pocket-sized AMT card. In the following year when the card was provided without an education program, the rate of cognitive screening fell to 13.4%. (p
Research Interests:
Page 1. 84 Control of Chronic Pain Robert D. Helme1 and Benny Katz2 1 Barbara Walker Centre for Pain Management, Fitzroy, Victoria, Australia, and 2 Pain Management Clinic for the Elderly, Victoria, Australia INTRODUCTION ...
Research Interests:
... Benny Katz GERIATRIC THERAPEUTICS Editors: Michael Woodward, Director, Aged and Residential Care Services, Rohan Elliott, Clinical Pharmacist, Graeme Vernon, Senior Drug Information Pharmacist, Francine Tanner, Clinical Pharmacist,... more
... Benny Katz GERIATRIC THERAPEUTICS Editors: Michael Woodward, Director, Aged and Residential Care Services, Rohan Elliott, Clinical Pharmacist, Graeme Vernon, Senior Drug Information Pharmacist, Francine Tanner, Clinical Pharmacist, Austin Health; Robyn Saunders ...
Research Interests:
Chronic pain is more prevalent in older persons than in young adults. In this review the physiological, pathological, and psychological reasons for altered pain sensibility in older persons are explored and strategies for the management... more
Chronic pain is more prevalent in older persons than in young adults. In this review the physiological, pathological, and psychological reasons for altered pain sensibility in older persons are explored and strategies for the management of pain in older persons described. The evidence suggests that altered physiology of peripheral and central pain mechanisms combine with psychological attitudes, such as stoicism and reluctance to confirm the presence of pain, to raise pain threshold. However, once pain is experienced, older persons describe the same severity, quality, and psychological disturbance as younger persons. There is some evidence to suggest that the complaint of pain in the presence of pathology is reported less often in older persons. On the other hand, the presence of persistent or recurrent clinical pain may have a greater impact on the psychological, social, and physical function of older adults. It is also clear, however, that further empirical studies are required in order to delineate the age-related differences and similarities in the chronic pain experience. Management of chronic pain in the elderly requires meticulous diagnosis of the causal pain mechanisms as well as a holistic approach which gives due regard to psychological and social consequences of pain.
Research Interests:
This article presents the development and initial testing of a comprehensive pain chart for the assessment, management and documentation of pain in older people in subacute and residential aged care. The pain chart was developed from... more
This article presents the development and initial testing of a comprehensive pain chart for the assessment, management and documentation of pain in older people in subacute and residential aged care. The pain chart was developed from existing assessment scales and pain indicators, and is targeting needs of older people in residential care and geriatric hospital settings with high prevalence of cognitive impairments. The chart is based on self-report of pain but allows for observation of pain-related behaviours for those unable to report pain. The chart consists of one evaluative and one documentation dimension, and was evaluated by a group of clinicians in geriatric hospital care (n = 15) and residential aged care (n = 6). The chart was found to be content valid, informative and easy to use, facilitating clinical assessments and monitoring, and assisting visual readings of patients’ temporal pain trends.
Research Interests: Documentation, Pain, Dementia, Pain Management, Humans, and 15 moreOlder people, Nursing Homes, Hospitalization, Chronic Disease, Female, Male, Diffusion of Innovation, Aged, Geriatric Assessment, Medical Records, Pain Measurement, Homes for the Aged, Cohort Studies, Psychology and Cognitive Sciences, and Medical and Health Sciences
Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our... more
Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our Privacy Policy. ... Skip Navigation Links Home > January ...