From time to time, professional journals and edited volumes devote some
of their pages to considerations of pain and aging as they occur among
the aged in different cultures and populations. One starts from several
reasonable assumptions, among them that aging per se is not a disease
process, yet the risk and frequency of disease processes increase with
ongoing years. The physical body's functioning and ability to restore
all forms of damage and insult slow down, the immune system becomes
compromised, and the slow-growing pathologies reach their critical mass
in the later years. The psychological body also becomes weaker, with
unfulfilled promises and expectations, and with tragedies that visit
individuals and families, and the prospect that whatever worlds remain
to be conquered will most certainly not be met with success in the
rapidly passing days and years that can only culminate in death. Despair
and depression coupled with infirmity and sensory and! or motor
inefficiency aggravate both the threshold and the tolerance for
discomfort and synergistically collaborate to perpetuate a vicious cycle
in which the one may mask the other. Although the clinician is armed
with the latest advances in medicine and phar- macology, significant
improvement continues to elude her or him. The geriatric specialist, all
too familiar with such realities, usually can offer little else than a
hortative to "learn to live with it," but the powers and effectiveness
of learning itself have declined.
