CHAPTER 1
 INTRODUCTION

 The increased number of aging persons has stimulated researchers to define the

concept of aging as viewed by older adults in our society. Rowe & Kahn, (1998) define

successful aging as the avoidance of disease and disability, social involvement and high

level of cognitive and physical function. Success, according to their definition, includes

few physical limitations, health, and the absence of chronic pain. Most adults over 55 yrs

of age do not report problems with daily activities such as: walking, bending and

stooping without assistance. In this age group, however, chronic pain can limit the level

of functional activity. A chief cause of chronic pain and disability among adults over 55

is osteoarthritis

 The experience of chronic pain in the elderly is both a physiologic and emotional

experience. Although rooted in sensory stimuli, pain also has an important overlay from

an individual's culture and experience (Porter, et al. 1996). Among all age groups pain

can be defined as an experience with both a sensory and emotional component, but for

the elderly adult, pain may signify a chronic condition that is not always managed

effectively with drug treatment. The most frequent cause of chronic pain and total

disability reported by the older adult is arthritis (Affleck, et al. 1999; Felson, 1988;

Mobily, Herr, Clark, & Wallace, 1994; Praemer, Fumer & Rice, 1999; Schlesinger,

2001).

 The American Geriatrics Society suggests using both pharmocologic and non-

pharmocologic methods to achieve a greater degree of pain relief (American Geriatrics