Prevailing over Pain: Human Ecology Faculty Help Hundreds of Thousands of New York City Seniors Cope with Persistent Pain

Article excerpt

Alan Abrahams, a 79-year-old living in the Murray Hill neighborhood on Manhattan's east side, turns to Duke Ellington and George Gershwin to tune out his chronic pain. He plays jazz standards at his 110-year-old Chickening studio grand piano in the corner of his apartment, and the aches from his arthritis, bursitis, and spinal stenosis fade.

[ILLUSTRATION OMITTED]

"I'm not bad, but I can guarantee there wouldn't be any money in my tip jar either," he said. "I've found that the greatest pain relief is my mind. If I come up with diversions for my mind, the pain becomes much more bearable."

For Susan Heller, 82, relief doesn't come as easily. She can barely write because of her arthritic fingers, and she endures back, leg, and hip pain from a fall that nearly paralyzed her a few years ago. Sitting hurts. Standing hurts. Walking hurts. Cold weather, rain, humidity--all of them intensify her pain.

[ILLUSTRATION OMITTED]

Physical therapy and an assortment of medications help keep Heller's discomfort at bay, but most times "the pain takes over," she said. "No matter what you try to do to make it go away, it's always on the back of your mind, if not the front. It comes back at you every time."

Abrahams and Heller are two of hundreds of thousands of seniors in New York City coping with persistent pain and suffering its harmful physical, social, psychological, and economic consequences. It forces a complex arithmetic, as they weigh the effect to their bodies, minds, and bank accounts of prescription drugs, exercise routines, physical therapy, surgeries, and other treatment plans. Left untreated, chronic pain can lead to more crippling conditions and rob the elderly of their independence.

With such seniors in mind, the College of Human Ecology and Weill Cornell Medical College (WCMC) have partnered with the Columbia University Mailman School of Public Health to establish the Cornell-Columbia Translational Research Institute on Pain in Later Life (TRIPLL), a community-based center for improving pain prevention and management in people age 65 and older, with a special focus on ethnic minorities. Funded by a five-year, $2 million grant from the National Institute on Aging, TRIPLL researchers aim to understand and overcome the barriers to pain management in seniors and to speed behavioral, social science, and medical research into clinical practices, intervention programs, and policies. TRIPLL emphasizes non-pharmaceutical treatments, such as regular exercise and mental stimulation, as well as strategies older adults can use at home to alleviate cancer-related and non-cancer pain.

"Poorly treated pain has profound consequences for older adults," said TRIPLL director M. Cary Reid, a geriatrician at WCMC who cites estimates that as many as 40 percent of seniors living independently in the U.S. suffer from chronic pain. "It can and all too frequently does lead to a decline in one's physical function, quality of life, and overall health. Unfortunately, older adults and their doctors often dismiss chronic pain as part of aging, causing it to be neglected. With TRIPLL, we want to raise this overlooked issue and improve how we treat pain in older adults."

TRIPLL arose from the Cornell Institute for Translational Research on Aging (CITRA), a College of Human Ecology initiative to link Cornell researchers with New York City senior care providers that has been funded by the National Institute on Aging since 2003 as an Edward R. Roybal Center for Translational Research on Aging. (TRIPLL continues as a Roybal Center, one of 13 nationally.) With its special focus on persistent pain, TRIPLL builds on CITRA's existing ties with front-line staff caring for the elderly at senior centers, hospitals, and retirement communities to include home health care agencies and nursing homes. Through this research-ready network, which includes partnerships with Memorial Sloan Kettering Cancer Center, the Hospital for Special Surgery, and the Visiting Nurse Service of New York, it reaches more than 300,000 elderly New Yorkers in the city's five boroughs. …