Managing Pain

What is pain?

• The patient's report of his/her pain must always be received as true
• Hurting or discomfort
• A condition that can cause physical, emotional, or spiritual distress and contribute to financial distress
• An experience that can only be felt and described by the person with the pain
• Pain affects everyone involved
• Older adults may describe pain as aching, burning, gnawing, grabbing, being uncomfortable, and soreness
• Confused patients, those with limited understanding, or those that cannot speak for themselves may have behavior changes such as pacing, moaning, agitation, grimacing, and furrowed brow that can indicate pain

What to report to the hospice team?

• How severe the pain is.  It can be reported as a number using 0 as no pain and 10 as the worst possible pain imaginable.  Other ways of reporting pain are also available such as, mild to severe, using different types of pictures.  Ask your nurse to tell you more about these options.
• Where the pain is located
• If the pain keeps you from doing your usual activities
• What makes the pain worse
• What makes the pain better
• How often are you taking pain medication
• Any side effects of the medication (common side effects include:  constipation, nausea, vomiting, sleepiness, dizziness, itching)
• Concerns about the medications, how to take them or how to administer them
• If you are becoming irritable from lack of sleep because of the pain

What can be done?

The good news is that there is much you, your caregiver, and the hospice team can do for managing pain.  They will try to find the reason for the pain and discuss treatment options with you.  Medications are usually necessary to relieve pain - the nurse will give you information about the medicines, when to take them, and what you need to know.

• It is important to take or administer the medicines as ordered before the pain becomes too severe to get relief.
• Many side effects can be treated and/or may even stop after taking the medication for a few days.
• Other things that can make the pain better are:
  • Relaxing activities such as listening to music, light massage, soaking in a tub of warm water, or guided imagery (picturing enjoyable and relaxing scenes to take one's mind off the pain)
  • Distracting activities such as watching TV, playing a game, or just thinking of other things
  • Heat or cold (such as a heating pad, warm compress, or ice pack)
  • Pleasant smells of certain plants or fragrances (aromatherapy) such as lavender, etc.
  • Storytelling, drawing
  • Deep breathing
  • Frequent rest periods
  • Pillows that add support to painful areas
• Ask your hospice care team to teach you how to use these ways of relieving the pain

Once medications are no longer needed, your hospice team will advise and assist you on the proper disposal of medications.