This audio presentation on the chalenges and barriers for effective pain management in the older adults by Keelar is very enriching and highly educative. The major take home for me is that older adults with chronic pain had been undertreated for several reasons which include provider factor- lack of experience and education, Systemic factor the believe that older adult should not be feeling much pain, or are not  different regulations on medication prescription, fear of litigations, fears of side effects of medication, and patient factor- believe that providers know s what is best for them, failure to express pain, fear of being labelled as an addict or fear of the addictive nature of some opioids anagesics. The speaker enumerated the importance of removing these barriers and provide optimal pain relief to the older adults suffering from chronic pain. She emphasized the importance of education on pain to the providers, the staff, patients and caregivers. She stressed the importance of institutionalized pain assessment in the elderly that procedures for pain assessments should be established, by routine screening and evaluation of pain, documentation. Staff education, needs for change champions to sparehead the educational initiatives and the role of quality improvement and assurance to follow up evaluation with patients, audit the charts and provide feedback and finally call for administrative support and committment because the leaders would be the ones that would provide most of the resources needed by the staff. In summary, the chronic pain of theolder adults cannot be cured but combination of interventions (non-pharmacologic and pharmacologic) should be used to relieve their pain to a fuctional level. Individual patients should set the goal for which he/she would be able to perform functions important to him/her.