Adopting Principles to Guide Pathways: The Best Model for Geriatric Pain Management.

Older adults experience the highest burden of chronic pain and pain-related disability. Existing pathways-multimodal, stepped, and stratified prove useful pieces but do not fully account for the complexity of geriatric care. This article argues for principles to guide pathways: explaining and adopting the biopsychosocial framework, applying it with nuance, addressing expectations, structuring limited time, communicating effectively, coaching rather than commanding, focusing on movement and function, and using safe pain-modulatory interventions. Together, these principles anchor individualized, patient-centered, and function-focused pain care.