Hospice: The Importance of Managing Pain

Healthcare provider giving woman medication in bed.Pain management is the careful use of treatments to reduce pain. Every person has a right to have relief from pain. The main goal of pain management in hospice is to improve quality of life. Pain management can also help improve a person’s physical and mental functions. You may have concerns about the use of pain medicine for you or your loved one. This sheet can help address these concerns. Discuss any questions you have with the hospice team.

Opioids are the most common type of medicine used to control pain in hospice. These include morphine, oxycodone, fentanyl, hydromorphone, levorphanol, and methadone

Non-opioids drugs, like acetaminophen and NSAIDs, can also be used and should be discussed with your healthcare provider.  

If pain persists and response is poor to opioid therapy, talk to your healthcare provider about other analgesic therapy choices.

It is important to note that elderly people are more likely to experience age-related kidney and/or liver problems with certain pain medicines. Please ask your healthcare provider which medicine would be right for your special situation and be careful when taking these medicines.

Why pain management is important

Managing pain is key to improving quality of life. Pain keeps people from doing things they enjoy. It can prevent them from talking and spending time with others. It can affect their mood and their ability to think. And pain can make it hard to eat and sleep, which can make other symptoms worse. 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 should not be held back until the pain gets severe. The plan for pain care may include more than one type of pain medicine. Different types may be given over time to see which work best. They can be given in many ways, like in a pill, IV drip, oral liquid, or patch. The doses may be changed to ensure the most effectiveness. The body can get used to a medicine so more of it is needed over time. This is called tolerance. It is a normal part of hospice pain care. It may not be possible to relieve all pain. But medicine can often provide a high level of relief.

Addressing concerns about pain medication

The use of pain medication may raise questions for you. The news contains stories of people addicted to pain medication. Addiction is when a medication is used after it is no longer needed. This is not an issue for someone in hospice. Pain medication will likely be needed until the end of life. You may also worry that pain medication will shorten life. This is not the case. Or you may worry that pain medication may make a person too sleepy to talk. Great care will be taken to treat pain but keep the patient alert enough to talk with family. In hospice, pain management is done carefully to prevent problems.

Managing side effects

The healthcare provider will explain the possible side effects of the medcine. These may include constipation, itching, nausea, vomiting, extreme tiredness, or mental fuzziness. Most of these go away after a short time. These symptoms will be treated.

Other ways to treat pain

There are other ways to help relieve pain. These can be used along with pain medicine. Ask the hospice team about:

  • Guided imagery

  • Therapeutic touch

  • Acupuncture

  • Massage

  • Pet therapy

  • Music or art therapy

  • Hot and cold therapy

The patient’s role

You play a vital role in managing your pain. This includes:

  • Telling the hospice team when you are in pain. Being clear about your pain makes it easier for the team to treat it.

  • Telling the hospice team about any side effects you experience.

  • Keeping a pain log. Write down when you feel pain and how strong it is. And write down what medicines you took. This helps the hospice team adjust the medicine as needed.

  • Taking the medicine as directed. Pain is harder to control if you wait too long to take the medicine. And you may end up needing a higher dose.

The family’s role

It may be hard for you to understand how your loved one feels. But the pain he or she has is real. You can help. Assist your loved one with tracking the pain in a pain log. Make sure medicine is given on time. Do not “save” or wait to give pain medicine. This can cause increased pain and withdrawal symptoms. Pain relief is most effective when medicine is taken on schedule and before pain gets severe. Remember that in hospice, good pain care is vital. It lets your loved one have the best quality of life during the time they have remaining.