Treating Pain at the End of Life

Treating Pain at the End of Life

opiods3Most of us don’t like to think about it or talk about it.

“It” is how to approach the final days on life.

“It’s the elephant in the room that can hold entire families hostage,” said Dr. Phyllis Hayes-Reams of Kaiser Permanente in southern California told the National Pain Report.

Part of Dr. Hayes-Reams’ work is palliative hospice care and treating pain for people at the end of their lives.

“It’s not just physical pain that we treat,” she said. “The suffering is not just physical but also can be psychological, spiritual and sociological in nature.”

The National Hospice and Palliative Care Organization estimates 1.2 million dying Americans and their families are helped each year. That number is much bigger when you consider hospitals, nursing facilities and home health care agencies are also dealing with patients at the end of their lives and the issues that cause physical or emotional pain or suffering.

Dr. Phyllis Hayes-Reams

Dr. Phyllis Hayes-Reams

“It is critical that the family be involved in these discussions and decisions on how to approach the end of a loved one’s life,” Dr. Hayes-Reams emphasized. “It is important for the physician and care givers to understand that no situation is exactly the same. There are many choices to make.”

The American Psychological Association talks about those choices on its website. Basic decisions need to be made like what kind of caregiver help they want or need and whether to receive care at home or in an institutional treatment setting.

Dying persons may have to make choices about the desired degree of family involvement in care giving and decision-making. They frequently make legal decisions about wills, advanced directives, and durable powers of attorney. They may make choices about how to use their limited time and energy. Some may want to reflect on the meaning of life, and some may decide to do a final life review or to deal with psychologically unfinished business. Some may want to participate in planning rituals before or after death. In some religious traditions, confession of sins, preparation to “meet one’s maker,” or asking forgiveness from those who may have been wronged can be part of end-of-life concerns.

“We have to demystify this process and have these discussions long before the end of one’s life,” said Dr. Hayes-Reams.

She notes there is an increasing trend of patients and their families being prepared. She emphasized that advanced directives, especially in hospice, make it so much easier for everyone involved.

Dr. Hayes-Reams who is board certified in internal medicine, geriatrics and palliative/hospice care, says the work that she does is humbling.

“Palliative care and hospice care are a process for the patient and his or her family, part of life’s journey. It is an awesome responsibility.”

Authored by: Ed Coghlan

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I watched 2 of my best friends slip away last year just 4 months apart. Both where paraplegic from car accidents and suffered a lot over the years in and out of hospitals. From everything to urinary tract infections from catheters to wound care. I saw them suffer a lot over the 8 year period they where my friends. One friend decided he had enough of the wheel chair life, he was paralyzed at the age of 16 and passed away at the age of 31. He let his wounds get infected and that stopped his heart. His last words to me where I’m tired of this wheel chair and all this never ending pain.

Then if that wasn’t bad enough just 4 months later my other friend died from hospital errors from the medication they gave him. Too much blood thinners can be deadly .The last time I visited him in the hospital his nose bled for no good reason, then I saw blood in his catheter bag. He was in renal failure and I knew that would be the last time I would see him.

So life can be cruel and not fair, these two friends suffered tremendously over the years I knew them and are in a lot better place now. End of life can be all too consuming but for these two friends it was a blessing to relieve them of being attached to wheel chairs and the never ending hospital stays and the pain they lived in.
I miss them very much. But knowing their standing now looking down upon me gives me a feeling of relief knowing they no longer have to suffer.