Pain at the end of Life — Common Questions
The percentage of people with pain increases to about 50% in the last few months of life. Pain associated with a life-limiting illness or at the end of life requires special attention and can best be treated by Hospice by The Sea. You may have concerns and questions about pain at the end of life.
Q. Will pain medications cause me to be sleepy all the time?
A. Opioid analgesics (morphine, codeine, etc.) can cause some sleepiness at first, but with continuing doses you will feel less sleepy and be able to perform normal activity. Sometimes the early sleepiness is due to lack of sleep you may have been having due to tolerating pain and the stress on the body from the on-going pain.
Q. Will taking opioids make me addicted?
A. Very few people who use opiates for pain relief ever become addicted or “psychologically dependent”. When opioids are prescribed by your physician to control pain, he/she begins with the lowest dose and increases it only if the medication is not controlling your pain consistently. As your terminal disease progresses, an increased dosage of opioid may be needed to control the pain on a continuing basis.
Q. If I take morphine too early, will it control my pain when it gets worse?
A. If your pain increases over time, your morphine dose can also be increased as needed. There is no reason to wait until your pain is out of control. In fact, it is harmful for your body and psychological health to tolerate pain.
Q. Does morphine or other opioids have many side effects?
A. All opioids can cause nausea, drowsiness, itching, and constipation. Side effects will diminish after a few days as your body adjusts and these side effects can be easily treated by your team from Hospice By The Sea.
Q. Will taking morphine hasten my death?
A. Morphine does not hasten death. Relieving one of the fear of pain and having to live with pain can hasten death. Morphine can aid in a more comfortable death, not a quicker one.
Q. Does starting morphine mean that death is imminent?
A. No, it is the degree of pain that dictates when morphine should be initiated. When morphine and other opioids are started at a low dose and increased as needed, these medications have been proven safe and effective in the management of severe pain.
Understanding Pain for Improved Quality of Life
Good pain management improves quality of life. Managing pain to live life fully is possible. It is important that the treatment of your pain is based on your diagnosis, stage of disease, response to pain and treatments, and personal likes and dislikes. Pain can be safely managed at home in a partnership with you and your team from Hospice By The Sea.
Use pain medications as prescribed.
If the directions are to take the medication at certain times or within certain time intervals (for example, every 4 or 6 hours), make sure this is done. Do not wait until the pain comes back to take the medications. This causes suffering and stress on your body. Each medication has it’s own individual duration of effectiveness. The directions will be reflective of the individual medications duration.
Medications for pain.
There are different types of pain medications to control pain at the end of life. Your physician will prescribe medication based on the type of pain you are experiencing. Pain medications include over the counter medications, such as aspirin, acetaminophen, and ibuprofen which can relieve mild to moderate pain. When these are no longer effective, your physician may recommend an opioid, such as codeine, morphine, hydromorphone, fentanyl or oxycodone which can be administered in different ways. These medications all require an order from your physician and will be obtained by Hospice By The Sea.
Good communication with your medical team from Hospice by the Sea about pain relief from the medication is critical, as each person’s pain and response to the medications is individual.
Managing Emotional and Spiritual Pain
In addition to medication, there are other ways to deal with emotions you might have when living with pain. Living with chronic pain can have a negative effect on your mood, outlook, relationships, and self-image. There are many support systems within your Hospice By The Sea team to assist you with emotional and spiritual concerns and needs. Hospice by the Sea has a Spiritual Counselor and Social Worker who can help you explore your feelings and spirituality.