- Palliative care is usually provided by palliative care specialists, health care practitioners who have received special training and/or certification in palliative care.
- They provide holistic care to the patient and family or caregiver focusing on the physical, emotional, social, and spiritual issues cancer patients may face during the cancer experience.
- Palliative care may be provided at any point along the cancer care continuum, from diagnosis to the end of life. When a person receives palliative care, he or she may continue to receive cancer treatment.
- Palliative care can help patients and their loved ones make the transition from treatment meant to cure or control the disease to hospice care by:
- preparing them for physical changes that may occur near the end of life
- helping them cope with the different thoughts and emotional issues that arise
- providing support for family members
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Pain Management
Assessment of pain
- It is important to ask about pain in every patient. A person who has had pain a long time may not show the usual signs of being in pain (facial expression, sweating, pale with fast pulse). They may just be quiet or depressed. Careful assessment of pain is essential.
- Questions you will need to ask include:
- How many different pains are there? It is useful to record them on a body map and ask about each one.
- Where is the pain and what does it feel like?
- How severe is the pain?
- How long has the pain been there?
- What makes it better or worse?
- Has any medication helped?
- Does the pain get worse with movement?
- Are there any changes in feeling of the skin at the site of pain?
Prescribe
There are 4 basic principles for the prescription of medications for chronic pain.
- By the mouth – giving analgesics by mouth is the simplest and most reliable method for most patients. If the patient cannot take tablets by mouth, then the subcutaneous, rectal, and buccal routes are alternatives.
- By the clock – constant pain needs regular analgesics to keep it away. Pain that is allowed to build up is more difficult to control. Do not wait for the pain to return but give analgesics at regular intervals according to their duration of action.
- By the ladder – the WHO analgesic ladder gives a logical way of increasing the strength of analgesia in steps as pain increases (see below)
- By the individual – tailor treatment for the holistic needs of the individual and remember to review, review, review.
