Pain and Symptom Management

Pain and Symptom Management at the End of Life

When your Bosque Trails Hospice team meets you, we will prioritize finding out what matters to you most at this time. We will continue to revisit this over time, as sometimes goals and wishes for the end of life change.

Pain and other symptom management are often top priority as someone transitions into hospice care. Our team will learn more about you and your preferences, explain different options to treat your pain and other symptoms and then make a plan together with you and your loved ones. It will be important to share what level of pain you are having, what your goal level of pain is, what things you are hoping to do or participate in, if being alert should be prioritized at this time and when or if that changes. Your care team might also ask you about different kinds of pain such as burning pain, throbbing pain etc as they may be treated with different kinds of medications or therapies.

Our Bosque Trails physician is board certified in Hospice and Palliative Medicine and they, along with our highly trained nurses, are able to tailor a regimen to your needs. If you are unable to communicate your pain level, they are trained to identify signals that you are in pain and will work with your loved ones to come up with a plan.

Questions to consider asking your team:

Will my pain medications make me sleepy or groggy?
- Finding the right balance of medications for your pain may take time and adjustment. Most of the time, if a pain medications makes you sleepy it will go away on its own after a few days. If it does not, an adjustment may need to be made. Sometimes, a patient has so much pain that they would rather be sleepy with better pain control than alert and in pain. Your team will have as many conversations with you about this as needed to make sure you are comfortable with your care plan.
Will I get opioids for pain and are they safe?
- Opiate medications are an effective option for aggressively treating pain related to terminal illness and our team is experienced in knowing when and how to prescribe them.
- We will only use opioids if we think it is safe and needed.
- When opioids are used as prescribed, especially at the end of life, addiction is not a concern. These medications are made for exactly this kind of pain and we do not want you to worry about taking them. If you feel worried or ashamed, please tell us so that we can talk to you and put your mind at ease.
- Many people have heard rumors that opioids hasten death. It is true that opioids are often used at the very end of life to keep patients comfortable when their time is near but they do not make death come any faster. In fact, the suffering related to being in pain can make a patient more fatigued and careful use of opioids can help them feel more alert.
What do I do if my pain gets suddenly worse?
- Sudden worsening or changes in the nature of your pain can signal worsening of disease or other complications. Alert your care team immediately. If it is after hours or the weekend, call the hospice number and the on call team will respond to you promptly.
What are the side effects of my medications?
- Medication side effects, including constipation and nausea, can be common and are easily controlled. Be sure to alert your care team to these so that your regimen can be adjusted or altered as needed.