Hospice care aims to give people who are not expected to live beyond six months the highest quality of life possible in their final months, weeks and days. Although hospice takes a holistic approach that involves the mind, body and spirit and addresses many aspects of this stage of a person’s life, a significant part of the work they do involves managing cancer pain management.
How Can A Cancer Patient’s Pain Be Assessed?
For many cancer patients, pain is a major challenge that can significantly impact their quality of life. Not only is pain unpleasant to experience, but it can also affect a patient’s ability to sleep, which can leave them feeling even worse.
Hospice teams are trained in assessing patients’ pain to determine the best course of action to provide much-needed relief and allow them to be more comfortable.
Some patients are able to communicate their levels of pain. In these cases, the hospice care team can ask them to rate their pain on a scale of one to ten, for example, to get an idea of how much they are suffering.
However, carers are also trained to look for non-verbal signs that an individual is in pain. This is useful not only for those who are unable to communicate their feelings, perhaps due to conditions like dementia, but also for those who are afraid to admit that they are feeling pain. Non-verbal scales can be used to assess these patients’ pain.
Some of the signs a patient is in pain include:
- Closing their eyes tightly or blinking rapidly
- Pacing, fidgeting or rocking
- Becoming withdrawn
- An increased breathing rate
- Resisting care
- Guarding certain areas of their body while turning or being positioned
- Holding their leg or arm muscles rigidly
- Moaning or sighing
Pain Medication For Hospice Patients
Medication plays a large role in the multipronged approach that hospice takes toward patient care and pain in particular.
For mild to moderate pain, acetaminophen or ibuprofen are typically the first medications that are given to patients.
However, for many patients with advanced cancer, these options do not do enough to alleviate pain.
Therefore, many patients are given opioids, which are much stronger. They work by attaching to opioid receptors within the brain to block feelings of pain and are effective for moderate to severe pain. S
ome of the opioids commonly given to hospice patients include hydromorphone, morphine, methadone and oxycodone.
Opioids For Cancer Patients
Many people have reservations about opioids because of the potential for addiction, but this is not a concern in patients who are nearing the end of their life.
Patients who are given these drugs are monitored very closely to ensure the right dosage is being administered and that side effects are kept to a minimum.
Over time, patients may need higher doses of these drugs to get relief, and their care teams may make adjustments or try a different approach.
For example, the method of delivery can be varied, with options including pills, patches, injections, and IVs as well as both quick-acting and slow-release formulas for ongoing relief.
Hospice pain medication protocol dictates that hospice care teams must ensure that a patient’s opioids are being stored securely and not being abused by other people in the home.
Other Medication For Hospice Patients That Can Help Alleviate Pain
In addition to medications like opioids that are designed specifically to relieve pain, patients might also be given what are known as adjuvant analgesics.
For example, because of their anti-inflammatory effects, steroids might be given to patients whose pain is related to inflammation. This makes them useful for bone and nerve pain.
Anticonvulsants are another option for controlling some types of nerve-related pain. For pain that seems to be aggravated by muscle spasms and tension, anti-anxiety medication may be administered.
Bisphosphonates can prevent fractures in patients whose cancer has spread to their bone, which can help alleviate bone injury and pain. For severe pain, injected local anesthetics may be an option.
Emotional And Spiritual Approaches
Because hospice addresses a patient’s mind, body and spirit, pain management is not restricted solely to medication. Addressing emotional pain, such as anxiety, is essential as this often accompanies physical pain.
The physical symptoms of pain can increase anxiety while anxiety raises the body’s response to physical pain, so addressing it is essential.
This might be achieved with the use of medications such as Ativan or Valium, but hospice also offers visits from social workers and chaplains to meet emotional and spiritual needs.
In addition, hospice teams advise family members to be careful not to add to their loved one’s stress by arguing with or around them.
Reach Out To The Professional Hospice Care Team For More Info On Cancer Pain Management
If your loved one is suffering from pain resulting from cancer or other advanced illness and has been given a prognosis of six months or less to live, they are likely eligible for hospice care.
Get in touch with the caring team at Harbor Light Hospice to find out how they can help your loved one enjoy the greatest comfort possible as their illness progresses.