Pain control in palliative care
Pain management is often part of palliative care - also called end of life care - given to a person with a terminal or advanced progressive illness, such as cancer, to help improve their quality of life by minimising discomfort.
Palliative care teams are skilled at pain control which may be given at home, in hospital, in a hospice or a care home. A referral to a specialist pain clinic may also be arranged.
The type of pain relief offered will depend on the condition, the person's state of health and the severity and location of the pain.
The type of pain relief and the dosage may need to be adjusted until the appropriate level is reached.
Pain relief may be given as tablets, skin patches, suppositories, under-the-tongue, injections, or through an IV drip.
In some cases the patient is able to have some control over a pump that supplies pain relief for periods of extreme pain.
The type of painkiller used can include paracetamol, opioid medication, or medication designed for conditions like epilepsy or depression that also has a pain-relieving role.
It can help to keep a pain diary to help doctors or nurses understand when pain returns between doses of medication.
Long-term use of strong pain relief medication can cause side-effects, including constipation, nausea and vomiting, dry mouth, itching and skin sensitivity, vision changes, problems urinating, breathing problems, drowsiness, unusual dreams, confusion, or muscle twitching. Medication and advice on coping with these symptoms will be given.
Nerve blocks and TENS electronic pain relief devices are other options.
Some people benefit from complementary approaches to relieve pain, including acupuncture, hypnotherapy, or relaxation therapy.