Learning to Endure Long-Term Musculoskeletal Pain in Daily Life at Home: A Qualitative Interview Study of the Older Adult’s Experience

Abstract

Background: Worldwide, there is an increasing number of older adults, the majority of whom remain living at home. Not infrequently they live with long-term pain, especially musculoskeletal pain, which is associated with increased disability (physical, psychological, social) and a negative impact on quality of life. A deeper understanding of how older adults experience living with this type of pain is needed in order to improve well-being and quality of life. The study focused on the actual experience by living with this global, prevailing and disabling type of pain. The aim was to describe commonalities in how older adults endure long-term musculoskeletal pain in their daily life at home. Methods: This inductive, descriptive study included qualitative semi-structured face-to-face interviews with 19 participants (66 to 88 years) in their homes. Qualitative content analysis by Graneheim and Lundman was used to identify themes crossing participants' experiences of enduring long-term pain in their daily life. Interviews were audiorecorded and transcribed verbatim. Results: All participants felt forced into "learning to live with pain" (main theme), in order to endure their pain. In time, they learned that: taking the pain as it comes, one day at a time; balancing the pain with activity, thoughts and emotions; self-talking; trying to be less of a burden to family and others; and capturing, enjoying and valuing moments of pleasure (sub-themes) helped them endure the pain. Conclusions: This experience was dominated by learning. The approaches generated to learn to endure pain in daily living by these participants should be discussed with older adults in similar situations for further additions, refinements and validation. Nurses can help to ease the older adult's suffering by tailoring individualized and holistic care focused on guiding the older adult in learning to live with pain and preserving and promoting health and well-being with a maximum of care and a minimum of intrusion.

Suffering in silence: a qualitative study of older adults’ experiences of living with long-term musculoskeletal pain at home

“…The sedentary lifestyle with limited social interaction and access to the world might worsen the older adults' situation. The findings in this current study regarding resigning and incorporating the pain as a natural component in the process of aging, is similar to findings by Gillsjö et al (2012Gillsjö et al ( , 2013. However, the findings in Gillsjö et al (2012) included the components ignoring and struggling as ways to deal with pain in life, which were not explicit in this current study.…”

“…Research is needed to understand how it is to live with this type of pain, in order to tailor individual and holistic interventions that preserve and promote health and well-being (c.f. Brown et al 2011;Cairncross et al 2007;Gillsjö et al 2013;Kumar and Allcock 2008;Nijs et al 2020;Vadivelu et al 2011). The aim of this study is to deepen the understanding of how older adults' experience living with longterm musculoskeletal pain at home.…”

“…In addition, there is a need to take into account that healthcare problems such as pain and the situation as a whole often is accompanied with comorbidities and frailty. A holistic approach is needed in the overall management of pain to provide appropriate health care (Lohman et al 2017;Nijs et al 2020;Reid et al 2015;Vadivelu et al 2011), a care that guides and supports the older adults based on their needs (Gillsjö et al 2013).…”

“…Research shows that they found their own ways to deal with pain ranging from ignoring, struggling, to adjusting and resigning. However, they had a feeling of being forced into learning to live with this type of pain on their own, which needs to be acknowledged in the provision of health care (Gillsjö et al 2012(Gillsjö et al , 2013. The complexity associated in living with pain requires an integrated personcentered multimodal approach that includes services and interventions from health-and social care teams providing adequate medication, nursing interventions, psychological support, and rehabilitation.…”

The growing research field of patient education and learning: The significance of a Nordic network

“…Many lack professional guidance and must learn on their own how to live with pain. 26 Based on the didactic method described above, a method called 'Reflective STRENGTH-giving Dialogue' 27 has been developed and tested in home-based healthcare.…”