Chronic pain makes you impatient and less ambitious – the idea of wandering round the shops or meeting a friend for coffee can feel a bit like planning to build a space shuttle to check out the stars; a nice idea but a bit over-reaching at the moment.
It makes people look different too. The patient with pain looks greyer, older, sometimes a little bit smaller. They can be less generous. And the accumulation of that pain over a long period changes them.
‘Pain is exhausting – it undermines dignity, changes personality and drastically reduces quality of life,’ says Paul Cann, director of policy at Help the Aged. Yet he believes that pain is not being taken seriously by services, which if we think about it is as absurd as finding out that the steering wheel is not being taken seriously by racing drivers.
A recent survey by Help the Aged revealed that two-thirds of the 1,000 people surveyed wanted pain management to be made a key indicator of trust performance. Respondents felt pain was too often treated by doctors as an inevitable part of ageing rather than something they might want to do something about.
Some doctors may struggle with unexplained patient pain and it may be that patients could, in the language of the modern health service, benefit from empowerment around the issue. Empowerment in the form of a cattle prod, for example. Every time the doctor seems to be struggling to understand, the patient can prod them and shout: ‘It’s a bit like that but mine lasts longer’. Won’t make the pain go away but it might make them feel a bit better for a short while.
It is telling perhaps that despite a decade of modernisation that has revolved fuzzily around ideas like ‘choice’ and ‘patient-centred care’ we can find ourselves listening to patients clearly saying that pain is not being taken seriously. Now of course that may be simply a bit of useful feedback from Help the Aged and maybe services will take it into account in their pain clinics and post-qualification training but perhaps there is a slim possibility that it might tell us something about the personality of modern services? Something about the patient experience still being lost in the processes and protocols? Something about services still not listening and still – just sometimes – managing to miss the point?
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