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End of Life Care

Dealing With Pain: How to Help Your Loved One

Caregivers can help with relief and pain prevention

Article Highlights

  • Assess your loved ones pain
  • Communicate everything to the doctor
  • Keep a pain record

En español | Facing pain at the end of life is a common concern, but it is often avoidable and treatable. As a caregiver, you may have to help your loved one through the important process of pain prevention and relief.

See also: Managing symptoms at the end of life.

The Importance of Addressing Pain
Pain is not only unpleasant, it can also cause a variety of problems, including disturbed sleep, trouble focusing, fatigue and emotional effects such as isolation, depression and worry. Not to mention, it can also interrupt a person's ability to enjoy life.

Fighting pain is so important that in 2001, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) introduced new standards that require all health care facilities to assess and manage pain effectively. Many institutions now include pain as the fifth vital sign in their care of patients, joining temperature, blood pressure, pulse and respiratory rate.

Getting Help for Your Loved One
If you are caring for someone in pain, help them explain the following details to their doctor. If you're worried they will either clam up or play down their pain during the visit, ask them these questions before the appointment and take notes on how they answer.

  • What is the location of the pain?
  • When did it start?
  • Of your treatment thus far, what works and what doesn’t?
  • Is the pain constant or occasional?
  • What words best describe the pain: stabbing, throbbing, aching, etc.?
  • What relieves the pain, if anything, and what makes it worse?
  • How is the pain affecting your quality of life?


Keeping a Pain Record

Keeping track of pain throughout the day will help doctors know if medication levels are right. If possible, have your loved one rate his or her pain from zero (no pain) to 10 (unbearable pain) at different times throughout the day. If he or she is unable, do your best to keep track yourself. Make note of what eases the pain (medication, rest, etc.) and what makes it worse (overexertion, lack of sleep, etc.). If your loved one's pain levels, once identified, do not subside with medication, go back to the doctor and have him or her adjust the dosage or switch medications, if possible. Also consider a pain specialist or clinic if the pain persists. 

Ways to Beat Pain

  • Don’t wait until chronic pain is too severe to treat. Pain management is partly about prevention. Like many health issues, it is easier to prevent than to treat. This means making sure your loved one is taking the medication when it is time to take it, even if he or she is not feeling much pain at that time. If he or she can’t wait until it is time to take the next pill, then the dosage is not strong enough: talk to the doctor about this.
  • Be assertive. Make sure your loved one is assertive, and tells the doctor he or she will not tolerate under-treated pain.
  • Demand comfort care in advance directives. Help your parent or loved one be clear and specific in this request.
  • Speak up. Become an advocate for a loved one who cannot speak for him or herself.
  • Keep a record. Have your parent or loved one note location, time of day, severity and what relieved the pain. If he or she is unable to do this, keep track yourself. Bring this with you to the emergency room or clinic.
  • Make pain known. Make sure your loved one identifies pain levels for home-care and hospice nurses at each visit.
  • Understand doctor’s orders for pain medication. Know the frequency, dose and type. Ask questions and make sure your loved one is getting exactly the right dose.
  • Get ample supplies. Insist that your loved one's doctor provide enough pain medication for weekends and holidays.
  • Gather contact information. Get the names and phone numbers of doctors covering for your loved one's physician.
  • Ask to speak to the medical director or nursing supervisor. This may become necessary when you are caring for someone who has been hospitalized and nurses fail to address his or her pain.
  • Be prepared. Expect medication amounts to increase near the end of life.
  • Consult a pain specialist. If the doctor isn’t addressing your loved one’s pain well enough, seek out a pain specialist — these can be anesthesiologists, neurologists, neurosurgeons, psychiatrists and orthopedic surgeons. There are also experts in specific types of pain, such as headache and nerve pain.

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