The American journal of hospice & palliative care
-
Am J Hosp Palliat Care · Jan 1998
ReviewCancer pain management: newer perspectives on opioids and episodic pain.
Cancer pain is significantly undertreated, but the current armamentarium of opioids and other analgesics are such that no cancer patient should be in pain. The guidelines for the treatment of cancer pain suggest that a long-acting, preferably oral, opioid be administered around the clock for persistent baseline pain, along with a short-acting oral opioid for episodes of breakthrough pain. Morphine is the gold standard for ATC opioid treatment, and OTFC is emerging as a potent agent for the management of breakthrough pain. The careful assessment and management of persistent cancer pain and breakthrough pain will help realize the goal of optimal pain management for all cancer patients.
-
Effective hospice care is dependent upon a caregiver who is able to with-stand the physical and emotional ardors of the experience. Direct support for the family caretaker is as needed and valuable as the direct care hospice agencies provide to patients. Massage was found to be successful in addressing many of the stress of primary caregivers. Nearly all of those who participated in an outreach project that used massage as a respite intervention reported reduced physical and emotional stress, physical pain, and fewer sleep difficulties.
-
Am J Hosp Palliat Care · Nov 1997
Case ReportsGoing one step further: skilled pain assessment and the art of adjuvant analgesia.
Evolving pain management practice has two phases: 1) the development of confidence and competence in prescribing opioids at whatever dose is needed to control pain; and, 2) advanced assessment skills and understanding when adjuvant analgesics must be employed with or without opioids to manage certain types of pain. A growing reliance on opioids alone is illustrated in case study by a nurse pain consultant. Dramatic improvements occur in patient function and coping when clinicians move beyond the sole utilization of opioids to understand the importance of skillful assessment of the patient's experience and the artful use of adjuvant medications.
-
This article is designed for hospice leaders and volunteers to explore creative ways to deal with the stagnancy that can occur in volunteer programs. Specific strategies, such as nurturing caregivers, transitioning into a gift-based program, and integrating spirituality and creativity into volunteer efforts, provide the focus of the article.