There was a reluctance in many of my co-workers to discuss the fact that the patient was not going to make it, was not going to be cured. Hospice care marks a transition from the health care team's efforts at curing a disease to a new period of providing pain relief and emphasis on quality of life for the patient and family. The hospice patient care team includes physician, nurse, social worker, chaplain and volunteer. And in most cases, there is a sense of relief, for both the patient and the family. Our emphases are different than the acute care setting.
Pain relief is the immediate priority.
Each member of the hospice team is committed to pain relief because it is difficult to imagine any meaningful quality of life without relief from pain. There is the source of pain from the disease itself, and there can be severe headaches, muscle ache, stiffness, constipation, bedsores. We listen very carefully to what our patient says the needs are, and we medicate accordingly. In hospice care, we discuss the need for pain relief with the family and we can teach them to administer medications. Frequently, patients can feel as if they have no voice, that decisions are being made without their input.