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Evidence to Improve Care

Palliative Care

Care for Adults With a Serious Illness


6

Management of Pain and Other Symptoms

People with identified palliative care needs have their pain and other symptoms managed effectively, in a timely manner.


Management of pain and other symptoms is an important part of high-quality palliative care and an integral component of the individualized care plan. It is important to consider nonpharmacological and pharmacological management throughout a person’s illness.

Not all patients who receive palliative care will experience the same pain or other symptoms, so it is important to assess the level and range of severity. Possible causes of symptoms, the person’s preferences, management of side effects, and the benefits and harms of intervention should also be assessed. If pain or other symptoms are identified, they should be managed promptly and effectively, and any reversible causes should be treated using evidence-based practice.

An example of pain and symptom management in the community involves the use of “symptom relief kits,” which are standardized kits designed to provide the nurse and patient with a supply of commonly used palliative care medications. Pain and symptom management require ongoing reassessment to ensure the efficacy of any interventions and monitoring for changes.

For Patients, Families, and Caregivers

Your health care team should assess your pain and other health concerns, and manage them quickly and effectively.


For Clinicians

Assess patients for pain and other symptoms. Ensure the delivery of high-quality management of pain and other symptoms.


For Health Services

Provide adequately resourced systems and services to ensure that health care professionals can conduct pain and symptom assessments and offer nonpharmacological and pharmacological treatments. Ensure that systems, processes, and resources are in place so that patients have access to timely and effective pain and symptom management.

Process Indicator

Percentage of people who receive palliative care who have documented assessments of their pain and other symptoms in their medical record

  • Denominator: total number of people who receive palliative care
  • Numerator: number of people in the denominator who have documented assessments of their pain and other symptoms in their medical record
  • Data source: local data collection

Structural Indicator

Locally adopted appropriate tools to assess pain and other symptoms for people with identified palliative care needs

  • Data source: local data collection

Outcome Indicator

Percentage of people who receive palliative care (or their caregivers) who rate the level of support to relieve their pain and other symptoms as excellent

  • Denominator: total number of people who receive palliative care (or their caregivers)
  • Numerator: number of people in the denominator who rate the level of support to relieve their pain and other symptoms as excellent
  • Data sources: local data collection; alternative source is InterRAI [Resident Assessment Instrument] tools
  • Similar question available in the CaregiverVoice Survey: “During the last 3 months of his/her life, while he/she was receiving homecare services, what is your assessment of the overall level of support given in the following areas: relief of physical pain, relief of other symptoms?” (Response options: “Excellent, Very good, Good, Fair, Poor, Does not apply, Don’t know”)
Pain and other symptoms

Pain and other symptoms are the effects of illness or treatment. Common symptoms associated with progressive, life-limiting illness may include but are not limited to the following:

  • Agitation
  • Anxiety
  • Changes in respiratory patterns and increased secretions
  • Constipation
  • Dehydration
  • Delirium
  • Depression
  • Diarrhea
  • Dyspnea
  • Fatigue
  • Nausea
  • Pain
  • Poor appetite
  • Vomiting

Pain and other symptoms can also affect activities of daily living (e.g., bathing, mobility, continence).

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