MANAGE SYMPTOMS
MANAGING SYMPTOMS Pain
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Pain (continued)
Spiritual and emotional concerns may also cause pain. Contact your team if you see symptoms of this type of pain. You may see this type of pain expresse d through: • Questioning the meaning of life, belief systems, or the meaning of suffering.
Your Care Team is skilled at evaluating pain and treating pain. You will hear them ask the patient about pain very often. We want the patient to be as comfortable as possible. Controlling pain can help improve quality of life for the patient and ease the caregiving burden. Four Seasons values life and does not use pain medications or any other treatment to shorten life. Only the person having pain can describe what it is like. Here are descriptions of physical pain:
• Talking about feelings of being left by God/higher power, or being angry with God/higher power. • Having pain and/or other physical symptoms.
• Being afraid to fall asleep at night or other fears. • Feeling a sense of emptiness or loss of direction.
• Mild, moderate, or severe: Your Care Team will often ask the patient for a “score” to rate the pain. ‘0’ means no pain, and ‘10’ is the worst pain. The patient is the only one who can give an accurate number to their pain.
• Sharp, dull, aching, stabbing, throbbing, hot, burning, needles, gnawing, cramping, etc. • Comes on very fast, or slowly builds up. • Constant, or comes and goes. • Worse with activity, or increases if staying still. • Occurs any place in the body, or in many places in the body.
CALL YOUR CARE TEAM IF:
• The patient develops new pain. • The patient experiences an increase in pain. • The patient is unable to take pain medications for any reason. • There are increased signs of discomfort for patients who cannot speak. • The patient experiences any side effects from medication. • The patient’s pain continues in spite of medication or other efforts.
Signs of Pain in Patients Who Cannot Communicate:
For people who may have a hard time describing their pain, such as children or patients with dementia, you may see changes in their actions if they are in pain, such as:
• Acting cranky, grouchy, or irritable • Wanting to be left alone, or covering up like they are trying to sleep
• Fidgeting, restless movements, pacing • Crying, moaning, or frowning • Curling up, rocking back and forth, or holding onto a part of their body
Saliva & Secretions
Managing saliva and secretions refers to techniques used to help clear excess mucus and saliva from the mouth and lungs, particularly in individuals with conditions that impair their ability to cough or clear secretions naturally. The goal is comfort, using a combination of gravity, physical clearing, and sometimes medicine, focusing on keep- ing the mouth moist and clear. How to Help: • Repositioning: Turn the patient onto their side (left or right) to help secretions drain out naturally, sometimes with the head slightly lower than the body to bring fluid forward for easier removal.
How to Help:
• Watch for the above signs and ask the patient if they are uncomfortable. • Give medications as ordered by the medical pro- vider. Your nurse will explain when and how much to use pain medications. • It is important to give pain medications before the pain becomes severe. It takes less time and medi- cine to get mild or moderate pain under control than for severe pain. • Change the patient’s position in their chair or bed. • Ask the patient if something warm or cool over the painful area sounds comforting. • Dim lights.
• Pain medications may be “long-acting” or “short- acting.” • Long-acting types are ordered to take on a regu- lar schedule with the goal of preventing pain. • Short-acting medications are often ordered when the pain begins to increase. • Your nurse will clearly explain what types and how to use the pain medications ordered. • Turn on soothing music or quiet the room depend- ing on the patient’s preferences. • Your Care Team will be able to offer other sugges- tions like massage, relaxation exercises, or music therapy to reduce pain.
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• Oral Hygiene: Use moist swabs (like sodium bicarbonate or alcohol-free mouth- wash) on a stick to gently clear the mouth, or apply lip balm/oil to keep lips moist. • Suctioning: Gentle, oropharyngeal suctioning can remove pooled saliva, but avoid deep suctioning as it can be uncomfortable and stimulate more secretions. • Fluid Management: Reducing IV fluids or oral intake (if appropriate) can decrease overall fluid produc- tion as death nears. • Comfort Items: A small fan blowing gently across the face can sometimes help moisture evaporate.
Common Side Effects from Pain Medications:
Most side effects from pain medications do not last very long. Many side effects get better or go away with simple actions. Your nurse will help you learn what you might expect and what to do about any side effects until they go away.
• Dry mouth • Drowsiness
• Upset stomach or nausea • Constipation
• Temporary confusion
866.466.9734 • FourSeasonsCare.org
866.466.9734 • FourSeasonsCare.org
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