Most patients and families who use hospice services expect that the hospice will make every effort to relieve the pain which afflicts their loved one. From the legal standpoint, the federal guidelines regulating hospice require the hospice to make every reasonable effort to assure that the patient's pain is controlled.
Part 2 Pain Management in Nursing Homes and Hospice Care Despite the availability of a wide variety of effective pharmacologic and non-pharmacologic treatments, understanding of pain remains a significant problem in nursing homes and hospices.
Glaser, RN, MS, CHPN Page 1 of 2 Hospice is a term given to specialized care that is intended to provide comfort and support to patients and their families when illness no longer responds to treatment and death is inevitable. Pain control is one of the central goals of hospice care.
|Assessment of Pain||Pain management in these patients should be considered a medical emergency.|
|Maybe you picked up a sheet of paper and gave yourself a deep paper cut. Perhaps you slipped in the shower and broke your hip.|
|Pain is often classified as acute or chronic. Acute pain, such as postoperative pain, subsides as healing takes place.|
|Abstract The aim of this article is to report on current provider evidence-based assessment and treatment practices for older adults with cancer in community-based hospice settings. When examining individual practices, the majority of patients had their pain assessed at admission using a valid pain scale|
|The goal is to prevent and relieve suffering and to improve the quality of life for people facing serious, complex illness.|
Most state laws governing hospice also make pain control a primary and required component of hospice care. Pain control during the last weeks of life can be a challenging patient management problem. Despite periodic entreaties in medical journals to improve pain control, inadequate pain management exists.
Patients with pain also are less able to commit to fighting their disease. In most cases, hospice services assure that patients receive pain medication necessary to control pain. A team approach is essential to address both the medical and psychosocial issues of patients.
The attending physician should be focused on the same goal and, in most cases, does order pain medication. Treatment of pain should be a top priority in end-of-life care. This must include the physical, emotional and spiritual aspects of pain management. Although patients do not die of pain, evidence suggests that untreated pain begets worse pain.
There is no doubt that opioid medications for pain are well accepted in the medical community. These medications are used successfully to control pain and keep patients comfortable.
However, effective pain management for the terminally ill patient requires an understanding of pain control strategies. It has been suggested that hospice care is associated with higher quality pain management and that patients enrolled in hospice are more likely than non-hospice patients to have a record of pain assessment and receive regular treatment for pain.
Clearly, prognosticating death is difficult for most physicians. Predictors of death, independent of age, gender and diagnosis, include: Improved Training Needed in Pain Management Despite the availability of a wide variety of effective pharmacologic and non-pharmacologic treatments, understanding of pain remains a significant problem in nursing homes and hospices.
Sources of ineffective pain management may be due to misconceptions, cultural mores, etc. For patient and family there may be fear of addiction, fear of opioids in general and fear of being labeled.
Although it is unclear why healthcare professionals fail to use the best available pain management techniques for their patients, several factors contribute to the problem. Clinical training in pain management—other than for pain specialists—is almost non-existent.
Few health care professionals feel that they have received adequate training in pain management in medical school or during their residency.
When will adequate pain treatment be the norm? Challenges in Pain Management at the End of Life. Is there such a thing as geriatric pain? Journal of the American Geriatric Society. Management of Pain in Elderly Patients with Cancer.
Clinical Practice Guideline Number 9: Management of Cancer Pain. Pain and its Treatment in Outpatients with Metastatic Cancer. N Eng J Med.
J Am Geriatr Soc. Journal of Pain Symptom Management. National Hospice and Palliative Care Organization. The tragedy of needless pain. Opiate therapy for chronic non-cancer pain:The agency for healthcare research and quality (AHRQ) guidelines for acute pain management cite non pharmacological interventions appropriate for clients who meet certain criteria.
List those criteria. Specifically addressed are the elements of a complete pain assessment, pain intensity scales, and the role of critical judgment in managing adult, child & infant pain effectively.
Objectives: Explain the goals of pain assessment. Describe three pain intensity scales. Understand how to assess pain in a confused or comatose patient.
In fact, the hospice Medical Director is required by law to make sure the patient's medical needs are met; these needs include medication for pain.
1. Medications. In most cases, physicians will begin to treat pain with what are called "over the counter" pain medications such as acetaminophen (Tylenol), ibuprofen (Motrin), aspirin or others. Assessment and Management of Pain in Inpatients PREFACE VA’s Health Services Research and Development Service (HSR&D) works to improve the cost, quality, and outcomes of health care for our nation’s veterans.
life simply does not occur in proper pain management. Instead of trying to escape from life, people with pain take the medicines to re-enter life. Good Pain relief offers better rest and more energy to be with family. Pain causes distress and suffering for patients and their loved ones Pain can also, increase blood pressure, heart rate and can negatively affect healing.
Managing the pain helps ease suffering. How pain is managed. Pain management is mostly done with medicine. Pain medicine works best when it is used regularly and on a schedule. It .