Using Expressive Arts Therapies to Aid the End-of-Life Transition for Older Adults: A Literature Review

This literature review presents the use of expressive arts therapies as they may be applied to end-of-life care for older adults. Death is inevitable and if given the chance to prepare, the expressive arts modalities provide a foundation to process the emotions associated with the ending of a life on earth. Expressive arts provide the opportunity to communicate in non-traditional ways which have the ability to locate subconscious themes. End-of-life care previously revolved around pain management. In more recent years it has evolved to caring for the whole person emotionally, socially, psychologically, and physically. Sources were found utilizing resources provided by Lesley University library services and included peer-reviewed articles and books. Findings included the benefits of music therapy and art therapy for older adults in end-of-life care. When applying expressive arts modalities to end-of-life care, patients are likely to benefit from increasing feelings of autonomy, clarity in their lives, and feeling a sense of community with other people in end-of-life care

Benzodiazepine Use and Dependence in Relation to Chronic Pain Intensity and Pain Catastrophizing

Benzodiazepines (BZDs), a class of sedative-hypnotic drugs, are at the center of an emerging prescription drug crisis. From approximately 1995-2015, overdose deaths involving BZDs quadrupled and average dose equivalents more than tripled. Specific concern has centered on elevated rates of BZD use among individuals with chronic pain, given that BZDs are generally not indicated for pain management. Consistent with negative reinforcement and motivational models of substance use, desire for pain alleviation may be a salient motivator of BZD use, particularly as individuals commonly report using BZDs for negative affect alleviation. The present study tested cross-sectional associations between pain intensity and clinically relevant BZD use patterns among individuals with chronic pain. We also examined the role of pain catastrophizing, a malleable transdiagnostic factor reflecting negative cognitive-affective pain responses. Participants were 306 adults (Mage = 38.7, 38.9% female) with chronic musculoskeletal pain and a current BZD prescription who completed an online survey study via Amazon Mechanical Turk. Hierarchical linear regression results indicated that pain intensity was positively associated with past-month BZD use frequency and BZD dependence severity. Logistic regression results indicated that greater pain intensity was associated with a 1.2 times greater likelihood of endorsing BZD misuse behaviors. Pain catastrophizing was positively associated with BZD dependence severity and likelihood of BZD misuse, after accounting for pain intensity. Initial findings implicate pain/pain-related cognitive-affective processes in higher-risk BZD use, and suggest pain relief is a common, yet underrecognized, self-reported motivation for taking BZDs. Future research should examine mechanisms underlying pain-BZD covariation and co-use behaviors