Pain

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Symptoms

Pain

PAIN
Pain is one of the most common symptoms for patients in hospice care
There are different ‘types of pain’ (nerve, body) – describe how the pain feels to the Hospice Team. It will
help with choosing the best medication to use.

1
The goal of hospice is to minimize suffering and maximize comfort at the end of life. Control of
pain is very important in achieving this goal.

2
It is important to know that pain can arise from physical causes, but also be the result of emotional,
spiritual, and existential distress.

3
Pain is often divided into three tiers. The Hospice Team may ask you to rate the pain on this scale to
help determine the most appropriate medication and dose.
Mild-moderate, pain on scale of 1-5 out of 10
Moderate-severe, pain of 6-8 out of 10
Severe, pain greater than 8
How to evaluate pain for patients with advanced Dementia – Take this Quiz

Pain Scale
Use this pain scale as a guide to assessing the severity of pain. However, the most important
measure is to ask and listen!

Treatments by Pain Severity
1
Mild-moderate
Tylenol (Acetaminophen), NSAIDs (Advil, Ibuprofen, Naprosyn, Aleve)
Lidocaine patch if localized area
‘Weaker’ Opioids for moderate pain- Hydrocodone, Codeine, Tramadol (Ultram)

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2
Moderate-severe
Opioids – Morphine (MS Contain, other brand names), Oxycontin, Fentanyl Patches,
Methadone
Gabapentin (Neurontin)

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3

Severe
Contact Hospice Team to help with proper dosing and timing of medications

Other things to try
Anxiety medications – Lorazepam ( Click Here )
Relaxation techniques – quiet room, soft lighting, music, meditation
Discuss whether visitors/company is helping or making things worse
Be open to discussing emotional and spiritual issues
Hospice has social workers and chaplains trained to discuss difficult topics. Use them!