Pain Management is one of the most important services provided by hospice. Although not all hospice patients will have pain, the control of pain is very important for those who do. The hospice philosophy recognizes that pain is whatever the person experiencing the pain states it is. The person alone is the expert regarding the pain that he or she is experiencing.

What is pain? Pain is an individual experience which is expressed in many ways. Pain is classified as 1) acute, which means it is sudden without warning, intense and generally doesn’t last very long; 2) chronic pain is a constant, persistent pain which lasts a long time.

How do we manage pain? The hospice nurse will want to know where the pain is, when it started, how frequently it occurs, how long it lasts, whether it is burning, aching, sharp in quality and what you did to relieve the pain. The nurse will ask you to rate your pain using your pain scale journal.

Chronic pain is a type of pain experienced by many people with certain conditions or diseases such as cancer. Chronic pain causes physical discomfort and emotional discomfort. The hospice nurse teaches the principles of managing chronic pain. Our goal is to eliminate pain or to reduce the pain to a tolerable level and then prevent the pain from returning. In order to do this, pain medications must be used on a regular basis in order to maintain an even level in the bloodstream at all times. If you wait too long or wait until the pain emerges again to take the pain medication, a larger dose will be needed to control the pain. We are trying to control and prevent pain, not wait until pain happens and then try to get rid of it.

Drug addiction is a common fear of most people when trying to control pain with narcotics. When narcotics are used appropriately as prescribed by the physician for pain relief, they do not become addicting. Addiction occurs when people abuse the drug and they pursue the use of the drug to give them a state of well being. This is not the case when it comes to hospice patients, so please do not become concerned about addiction at this time. There may be a craving or an over concern about the next dose in order to keep the pain from recurring. If this happens, it is not that you are addicted and need a drug, it may be that it is time for the medication to be increased to a stronger strength in order to control the pain.

Various Medication Forms. Medications come in many different types of forms: syrups, liquids, pills, capsules, rectal suppositories, injections, intravenous mixtures and also transdermal (“skin patches”). The physician will determine the medication which is most effective and easiest to take for the individual’s needs.

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