Promise Hospice provides all medications related to the patient’s diagnosis, as well as those related to comfort. Our Hospice physicians are experts in medication management and we want to ensure pain and other symptoms are effectively managed and the right amount of medications are taken. Additionally, patients on hospice services are also provided with medical equipment (e.g. hospital beds, wheelchairs, oxygen, etc.) and medical supplies (e.g. bandages, catheters, etc.) as needed and related to patient’s hospice care.

Fear of Pain

One of the most common fears seriously ill individuals have, is the fear of being in pain. Since palliative treatment and comfort is the focus of hospice care, special attention is given to pain control, with the prevention of pain being the ultimate goal.  Historically, pain has been under-managed in the care of serious illness.  Society often teaches us to fear addiction more than anything else and causes us to forget to look at the situation of seriously ill patients.

Addiction is not an issue with hospice patients for two reasons.  First, medications that may be addictive under certain situations are used in hospice to alleviate the pain associated with the end of life rather than to cope with the environment and social stresses of life.  Medications are being taken for physical symptom relief rather than out of social or emotional need.  Second, if a disease process would disappear and hospice care would no longer be needed, the pain and symptoms associated with end-of-life issues and the disease process would no longer exist and medication would not be necessary.  There is no longer a psychological or social need for the medication, and if a physical addiction has somehow occurred, it can be easily treated.

Key Principles of Pain Management:

• Pain must be addressed from a physical, psychological, emotional and spiritual perspective.
• Medications should be administered continuously without breaking the cycle of pain control.
• Changes in pain control needs must be monitored throughout the illness.
• Simplicity and thorough patient and family education increase the effectiveness of pain management.
• Dependency and addiction should not be a concern in the hospice setting. Patients and families need reassurance that high dosages or dosage changes are necessary and will not be harmful if administered according to a physician’s instruction.