Pain Assessment

• Doctors use a variety of pain relievers based on the severity and frequency of the pain the patient experiences. A doctor may ask you to describe your pain on a scale between one and 10, with one being the least severe and 10 being the most severe. Describe your pain as a 10 only if it's the worst pain imaginable. Tell the doctor your pain is at zero if you are not experiencing any pain or if it's completely relieved by the medication. Tell the doctor or hospice nurse if the pain is acute, meaning it came on suddenly and severely, or chronic, meaning it has remained fairly constant for a while.
  
  If your loved one is the one nearing the end of life, and is unable to speak, tell the doctors or hospice nurse when you believe he is experiencing pain. Even though a patient is unconscious and not speaking, he should still get relief from his pain. Look for signs of pain like moaning, labored breathing, restlessness and tense facial expressions.
  
  

Pain Management

• If pain is not very severe, you may be able to manage it using over-the-counter pain medications such as acetaminophen or ibuprofen, or a combination of the two. Stronger pain, however, requires prescription medicine. Do not feel weak or ashamed because you need more pain relief. Relieving pain effectively gives you a better quality of life and may even prolong life. You may have heard about painkiller addiction, but that is not a concern for a patient at the end of life.
  
  Opioid pain relievers offer effective pain relief for the end of life. If the patient can't swallow oral medication or needs more continuous pain relief, a doctor can place a a pump to deliver medication directly into the body through a muscle or IV site. Over time, the doctor may increase your dose of opioid pain relievers because the body builds up a natural tolerance to the effects of opioids over time. If you experience breakthrough or worsening pain, let your doctor know, and she can increase your dose, substitute a different type or form of medication or add a medication for more effective relief.
  
  Opioids cause side effects such as tiredness, confusion and constipation. When taking opioid pain relievers, take a laxative or stool softener to prevent or relieve constipation. Being tired and needing more sleep than usual is typical in the last few months of life. Doctors can sometimes alleviate confusion caused by opiates by switching medications, and sometimes the confusion disappears on its own once the body adjusts to the effects of the medicine.