1. Section Editor(s): Pfeifer, Gail M. MA, RN

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Unnecessary pain during the last two years of life. Most of the information we have about end-of-life pain comes from hospice or cancer patients. But a recent population-based study of 4,703 elderly people found the prevalence of moderate-to-severe pain in the last two years of life to be quite high, at 26%. And in patients with arthritis, the prevalence was 36%. As reported in the November 2, 2010, issue of Annals of Internal Medicine, the prevalence of pain remained nearly constant until the last four months of life, when it jumped to 46% overall and 60% in arthritis patients. Arthritis pain, in particular, can impair daily activities and lead to isolation and depression. The authors recommend that clinicians anticipate increased pain as death nears and refer patients to pain specialists or palliative care when needed.