Managing Pain

• It is what the individual says it is
• Hurting or discomfort
• A condition that can cause physical, emotional, or spiritual distress and can contribute to financial stress
• 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, soreness
• Confused patients, those with cognitive impairment, or those who cannot speak for themselves may have behavior changes such as pacing, moaning, agitation, grimacing, and furrowed brow that can indicate pain

How severe or intense 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 the options for reporting. There are also options for rating children’s pain.

• 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
• What does the pain feel like (burning, sharp, stabbing)
• Is the pain constant, or does the pain come and go
• How well the pain medication is working
• How often you are 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

The good news is that there is much you, your caregiver, and the hospice and palliative care team can do to manage 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
• 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

Ask your hospice and palliative care team to teach you how to use these ways of relieving the pain.

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