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Pain

In hospice care the definition of pain is both simple and profound:

"Pain is what the patient says it is"

Pain is one of the most feared symptoms of the dying process and is a major cause of the anxiety, depression, helplessness, loss of self-esteem, guilt, and anger commonly experienced by patients with advanced cancer.  Because up to 95% of cancer-related pain responds to treatment, inadequate control of pain in terminally ill patients is difficult to understand.

Pain is a complex physical and psychological experience.  To emphasize the many dimensions of pain, Dame Cicely Saunders uses the term "Total Pain" when describing the multiple causes of pain.  Just as growth in a cancer tumor causes increased pain, so do anger, anxiety, depression, and isolation.  Caring for a patient's psychological, social, and spiritual pain is not a frill - it is an essential component of good pain management.

The degree of suffering caused by pain depends on the context of meaning in which the pain is experienced.  When curative treatments result in pain, the pain has meaning because it is part of a treatment process that will probably lead to a cure.  Even though the patient experiences pain, less suffering is involved because the pain has meaning.

However, unrelieved terminal pain is meaningless and leads to feelings of helplessness and hopelessness.  These feelings are the source of the greatest suffering for the patient, family and caregivers.

More information about Pain: 

Chronic Pain Versus Acute Pain

Relieving the Fear of Pain

Physical Causes of Pain

Pain Assessment

Pain Management

Psychosocial and Spiritual Aspect of Pain

Four Pharmacological Categories of Pain

Hospice Concepts of Pain Control

Factors Influencing Patient Perceptions of Pain

Principles of Pain Control and Narcotic Therapy

Frequent Types of Pain and Medications Often Used

Myths and Misconceptions about Morphine

Non-Medical Pain Control Techniques

Control of Non-Pain symptoms

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