Managing Pain

Hospice believes that emotional and spiritual pain are just as real as physical pain and seeks to addresses whatever kind of pain a person may be experiencing.

Hospice nurses are experts on the latest medications and devices for pain and symptom relief. In addition, physical and occupational therapists can assist patients to be as mobile and self-sufficient as they wish, and they are often joined by staff and volunteers schooled in music therapy, art therapy and massage therapy. Social workers can help work through unresolved issues or practical problems causing distress. Finally, chaplains are available to assist family members as well as patients with counseling.

The hospice team will work with the patient to improve and maintain physical and emotional comfort. Nurses will also provide instruction on how to assess pain and give suggestions for dealing with it.

The first step is to get physical pain and symptoms under control. The nurse, doctor, and the hospice pharmacist will develop a medication plan that includes long acting medications to maintain comfort and short-acting medications for break-through or acute pain. Medications may be taken orally or topically (through the skin) depending on which method works best for the patient.

We often hear people express concern about the narcotic nature of some pain medications. Morphine and other pain medications are used in the smallest amounts needed to effectively alleviate pain while maintaining alertness. Occasionally, a patient develops tolerance to higher doses because of intense pain. Medication dosages are carefully monitored by the nurse and the patient's physician to ensure that the patient—and the family—remain comfortable.

Medications are based on the patient's goals for pain control. Some people choose to tolerate a higher level of pain in favor of remaining more alert. Some people prefer higher levels of medication in order to be completely pain-free. Some people work to achieve pain relief through alternative, drugless therapies. A hospice nurse will work to achieve your goals for pain control.

Besides medication, there are other methods available to manage pain and other symptoms. Massage is a proven way to reduce pain and stress, increase relaxation and overall sense of well-being, and improve digestion, breathing, and sleep. Licensed massage therapists can provide massage as often as twice weekly. Caregivers may also enjoy brief respites through shoulder, back and neck, or foot massage.

We also offer acupuncture for pain and symptom management. Our physical therapist can provide comfort through positioning consultation. Instruction on using heat and cold packs can also give relief.

Of course, not all pain is physical. Social workers can help to alleviate the pain unresolved issues or unreconciled relationships can cause. A chaplain can provide a listening ear and caring presence for those experiencing the emotional or spiritual distress often associated with dying.

Managing Pain