Older Adults_Bars-Geriatric Pain

FAST FACTS: Controlled Breathing & Guided Imagery

Controlled Breathing and Guided Imagery is used to help reduce stress that can cause muscle tension and increase pain.  The caregiver could also consider recording their loved one’s favorite music, poems, or prayers read by family members or clergy which their loved one could play at any time for stress reduction. 


  1. Controlled Breathing
    Help your loved one into a comfortable position.
  2. Instruct your loved one to close their eyes
  3. Do not allow your loved one to fold their arms or cross their legs to avoid impairment of circulation.
  4. Read the following out loud, slowly:
    1. Breathe in slowly and deeply
    2. As you breathe out slowly, feel yourself beginning to relax; feel the tension leaving your body. 
    3. Now breathe in and out slowly and regularly, at whatever rate is comfortable.
    4. To help you focus, breathe slowly and rhythmically.  Breathe in as you say silently to yourself, “in, two, three.” 
    5. Breathe out as you say silently to yourself, “out, two three.”  Or, each time you breathe out, say silently to yourself a word such as “I am peaceful”, or “I am relaxed.”  Find a word or phrase that helps you focus and slow your breathing.
    6. You may imagine that you are doing this in a place you have previously found very calming and relaxing, such as lying in the sun at the beach. 
    7. Peaceful images may be added by asking one of the following questions:  
      1. Can you remember any situation, even when you were a child, when you felt calm, peaceful, secure, hopeful, or comfortable?
      2. Do you get a dreamy feeling when you listen to music?
      3. Do you have any favorite music?
      4. Do you have any favorite poetry that you find uplifting or reassuring?
      5. If they are, or have you ever been religiously active- you could ask: Do you have favorite readings, hymns, or prayers?  Even if you haven’t heard or thought of them for many years, childhood religious experiences may still be very soothing. 

What else you can do:

  • Write down and share information about your pain with your healthcare provider
  • Consider using a Pain Diary to note important information useful to your provider
  • Try a non-drug treatment and document the impact on your pain in your Pain Diary


Adapted from: 1. Fouladbakhsh, J.M., et al., Nondrug therapies for pain management among rural older adults. Pain Manag Nurs, 2011. 12(2): p. 70-81. 2. The Nursing Home Pain Management Algorithm Clinical Trial, R01 NR009100,  7/1/05 – 4/30/10; Mary Ersek (PI) Used with permission of Mary Ersek and HPNA (2009). 

Revised 3/2020
PDF Download