Hospice Concepts of Pain Control
The following list includes some of the most important hospice
concepts of pain control:
- Diagnose cause(s) and type(s) of pain
- Select appropriate medication for specific type of pain
- Know the pharmacology of prescribed drug
- Adjust route of administration to patient's needs; use oral
whenever possible
- Keep it simple
- Titrate to effective dose; by the clock and by the World Health
Organization ladder
- Give analgesia at regular intervals
- Maintain pain control throughout 24 hour period
- Use adjuvant medications to improve analgesia and reduce side
effects
- Avoid drug combination that increase sedation without enhancing
analgesia
- Anticipate and treat side effects and complications
- Continue to monitor for increased pain
- Prevent acute withdrawal
- Continue to evaluate and manage emotional, social spiritual pain
- Remember no one optimal dose or maximal dose exists for morphine
- Remember addiction and tolerance are not clinical problems in
terminally ill patients
- Remember break-through pain is common; provide for relief
- Treat insomnia vigorously
- Offer cognitive and behavioral therapies when appropriate
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