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Pain Management and Symptom Control

The spirit of The Connecticut Hospice, Inc. is to encourage quality of existence for patients and families. Because of this abiding philosophy, pain and symptom control lie at the very heart of the Hospice program of care. Medical and pharmacological therapies control a range of debilities that, if untreated, sap a patient's strength, will, and even human dignity.

Professional expertise and an individualized care plan make possible a control of pain rarely achieved in other health care settings. Nowhere is this more evident than in the work of the hospice physician, nurse, and pharmacist. The physician, nurse, and pharmacist are important team members in evaluating pain and treating it pharmacologically. Artists, social workers, clergy, nurses, and professional and lay volunteers work with psychological and spiritual pain. As a team, they review the patient's status daily. In addition, consultants in several fields of health care complement the efforts of the medical and nursing staffs.

Prior to admitting a patient to the Hospice program, the Hospice physician confers with the family's physician. They retain open lines of communication. In the home care program, the family's physician acts as the primary physician. The role of the Hospice physician varies from case to case. In the inpatient unit the Hospice physician assumes the primary physician role. In both programs, medical direction is available twenty-four hours a day.

The care plan must be creative, innovative, and flexible to respond to the constantly changing challenges of irreversible illness. Some symptoms can be relieved by simple measures such as repositioning, massage, relaxation techniques, and distraction through arts and other activities. Yet medications are often crucial in alleviating physical discomfort.

In treating the patient, the Hospice physician and pharmacist are guided by repeated assessments, with adjustments in medications, and times of administration so that the patient will be as comfortable as possible.

An important principle in The Connecticut Hospice approach is that drug doses are carefully adjusted to each patient's physical make-up. This assures pain relief without loss of alertness. The Connecticut Hospice goal is to control symptoms while maintaining optimum functioning.
At Hospice, the patient's needs dictate the medication level. Medications are administered on a regular schedule, to eliminate not only pain, but also the fear of pain. Ease of administering is a key consideration also. Patients are spared injections whenever possible to make their lives more comfortable. Over 90 percent of the medications at Hospice are taken orally. Because of this, it is often possible for patients to be cared for at home.

When a medication is not available commercially in the exact dosage needed, the Connecticut Hospice pharmacist is able to meet individual needs. An active participant in patient care, the pharmacist attends morning rounds and weekly team meetings, serving as a source for current drug information and a consultant for changing drug regiments. Both the Hospice pharmacist and physician strive to educate others on the goals and parameters of hospice caregiving. Advances in symptom control present diversified and constant challenges. As Hospice physicians and pharmacists discharge their demanding duties, they are in the forefront of palliative care. Hospice remains identified by its excellence of symptom management and support.