Palliative Pain Management

Have you ever read three stories that are amazedly surprising? and that you can compare to. Have you ever thought about character or personality or your conflict or your setting? Well that is what will be talked about to and have you ever come up with a theme for each story and compare it? I have noticed in the pages of the text that was read that there were literary elements, one of the stories that I read is called, “liberty” by Julia Aivarez.

In almost every case of a terminal disease, pain is intolerable and seeing someone in such agony is heartbreaking. For example, Brittany Maynard, a 29 year old brain cancer patient who had to move to Oregon so she can avail of the Death with Dignity act. “Maynard knew that her form of brain cancer would be excruciating. She would endure swelling of the brain that would very likely cause seizures, painful headaches and the gradual loss of bodily function. Doctors know that for about 5 percent of the population, no amount of morphine can block the agonizing pain the terminally ill endure” (EDITORIAL: Dying with dignity). Palliative care can often be provided for the dying patients and alleviating pain to provide comfort for the dying has always been the priority. “Palliative care focuses on relieving the symptoms, particularly the pain, of incurable illness.” (Palliative Care) But, in relieving pain through the prescribed medications there are also side effects that are caused by the prescribed pain suppressors and two examples will be lethargy and it compromises breathing. In most cases the effectivity of the pain medication may no longer alleviate the pain. If a patient will be in such agony for the remaining days or weeks the quality of life is no longer present. The agony of pain prevents a patient from performing even just the bodily functions.

Yes, SFEAA is responsible for the Oktoberfest. I am the point of contact for APOC. Currently, all shifts are covered. All events are from 10a-12p, 2p-4p, and 6p-8p. If your department comes in after 8pm, we currently do not have reps to cover that time slot. If you would like to assign reps from ILR or Express to partake in SFEAA, please send me their names. However, it will be impossible to schedule events on all days that employees are here.

Dying due to an incurable illness can be devastating With responsibility of caretaking falling chiefly on the patient’s family. While dealing with the normal every day activities that families encounter, becoming a primary caregiver to the terminally ill is an emotional as well as financial burden. The ill person usually lives in the house of a family member, which forces the family to witness the person dying every day. Having to watch a person suffer in your own home is depressing to even the strongest of people and knowing there is nothing that can be done to stop their pain makes things that much worse. Studies have shown that people who receive a terminal illness diagnosis become depressed and develop anxiety. Because of the mood disorders that can

Last semester in clinical, there was a patient with sickle cell anemia and he automatically sparked an interest in me. The patient was quite young and was in so much pain that he could not even bear to be touched by the nurse and reported a pain level of 8. Before my encounter with this patient, I did not know much about sickle cell anemia and decided to do some research on this disease. In my research, I learned that a majority of these patients go through acute pain episodes that occur chronically. After learning this and thinking about the young boy in the hospital, I wanted to discover more about how the pain in these patients are managed and controlled.

The author indicates that specialists in controlling certain types of pain, such as the pain of terminally ill cancer patients, believe that there are very few patients whose pain could not be adequately controlled. Although there are some ways to help a patient's pain, these methods unfortunately do not help. Many patients become sedated and cannot interact with other people or their environment (Hawkins 22). Clearly, all of these reasons are examples of self- deliverance and a liberty to choose. No patient should have to undergo a prolonged painful death.

This study supported the idea of receiving hospice or palliative would be beneficial for patients and primary caregivers which reduce the negative symptoms and have an advantage for receiving hospice or palliative care which also support and be relevant to the thesis that I would like to research on.

Throughout ancient history, one can find many different examples of civilization, each with different geography, political systems, and cultures. Although many of these empires were prominent and influential, one could argue that the two most contrasting, impactful civilizations were perhaps Egypt and Mesopotamia. These two empires had entirely different circumstances in terms of the land they were erected on, the peoples both in the land and surrounding it, and the social customs that developed. However, in spite of the wildly differing conditions, both Egypt and Mesopotamia were able to develop in such a way that the two cultures were both in a position to leave behind impactful legacies that still influence the world today. Before one considers how Egypt and Mesopotamia differ socially and politically, one must first understand the different geographies that drove

Palliative care is a relatively new concept. Palliative care programs have become more numerous and better utilized since 2000 and continue to grow. It is now accepted that the palliative care model is appropriate for patients with life-limiting illnesses. Chan et al. (2013) stated that the ultimate goal of palliative care is to relieve suffering and to maximize the quality of life for dying patients and their families, regardless of the stage of illness or the need for other medical treatments (p. 133). As life-expectancy increases, there is a growing need for these services. People are living longer with chronic diseases and palliative care services can provide an extra layer of support to patients and their families. Evidence has shown that 13% - 36% of hospital inpatients qualify for palliative care services (Robinson, Gott, & Ingleton, 2014).

Long term condition (LTC) is a health problem that cannot be cured, at present, but can be managed by medication or therapies’ (Snodden., 2010: p1). There are more than 15 million people in England that are suffering from long term conditions (Department of Health., 2013). Long-term conditions are more common in older people. The percentages of people of over 60 having a LTC is 58 per cent compared to under that is 14 per cent (Department of Health, 2012). LTC is also more predominant in more deprived groups, such as the poorest social class as it has 60 per cent higher prevalence than of those in the richest social class. (Department of Health, 2012).

The first 48 hours of pain analysis and treating the pain of the patient to the hospice (or end-of-life patient in any other stetting) are crucial. However, the patient may be unable to speak and articulate his pain, or may be able to inadequately express the symptoms. One of the major concerns for those who are at the end of life is

A palliative approach can support and provide information for Anna and her family through her dementia progression.

When a person is diagnosed with terminal cancer can respond in different manners. Initially, there are patients that enter in a phase of denial, where he or she does not want to accept that the cancer is the cause of all the symptoms and consequently refuse the appropriate treatment. Depression is another and one of the most significant factors during this illness. In this moments the recurrent thoughts about death and the hopeless idea that there is not anything to do originate sadness, restlessness, and insomnia. Other symptoms can be added in the third case where the patient suffers from acute anxiety, inducing agitation, tachycardia, hyperventilation, panic disorder, etc. Anger for the injustice of being sick and a fighting determination are the resting two reactions in a person with a terminal decease.

Palliative care is a system of holistic care aimed to satisfy the requirements of the chronically ill, typically within their home and community rather than as an in-patient1. Hospice is based on the same principles of care, however, it requires that a patient be deemed with six months or less to live and that life-sustaining treatments be ceased, creating an important distinction between the two. Hospice and palliative care both provide comfort, but hospice is for comfort during end-of-life. Pain and palliative care patients have indicated that receiving that care not only reduced their pain that was once intolerable either completely or to a substantial extent, but it also maintained or increased their hope and outlook on life1. In this country, palliative medicine is a relatively new field of medicine. It wasn’t until 2014 that the WHO began to recognize “palliative and end of life care services as essential and integral to health systems worldwide”2.

The case study based on the palliative patient Mrs. Mavis looks at issues both the family and the patient are dealing with in regards to the end of life treatment Mrs. Mavis is receiving. Mrs. Mavis is a palliative patient, currently unconscious, who is dying and only wants comfort measures within her nursing care. This was made clear through her advanced care directive, which was made weeks before beginning to receive her end of life care. Mrs. Mavis’ comfort measures include pain relief, hygiene and keeping her comfortable. Mrs. Mavis’ family want her to have fluids and medications to help improve her health. They also want oxygen and pain relief to help with her breathing. Issues such as educating and supporting the family, pain management, the effectiveness of having an advanced care directive and pain assessment will be evaluated to determine the best effective interventions for Mrs. Mavis and her families care. Interventions that will be discussed through-out this essay include the use of analgesia medication, the use of subcutaneous injections and syringe drivers, emotional support for the family, effective communication, educating the family on Mrs. Mavis’ wishes and the importance of having an advanced care directive. These interventions will be evaluated to ensure they are the best practice for Mrs. Mavis’ care.