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Palliative Care and Pain Management

Author: Becky Li

Editors: Kevy Chen and Emily Yu

Artist: Leo Li

While much of healthcare revolves around curing diseases and prolonging life, an equally vital aspect focuses on improving the quality of life for those suffering chronic conditions or serious illnesses. Palliative care provides holistic medical care involving physical and emotional support, thus improving a person’s current care by alleviating suffering. 

Palliative care aims to enhance the patient’s quality of life by providing relief from physical symptoms and emotional stress for both the patient and their family. Notably, palliative care is not restricted to patients with a terminal diagnosis or those nearing the end of their life. Rather, this specialized care can commence at any stage of the illness and does not correlate with life expectancy. Those with short-term illnesses may recover or obtain optimal symptom management and no longer require palliative care.

Anyone with a serious, progressive, or life-threatening condition such as cancer, dementia, or heart failure may benefit from palliative care. The purpose of these services is to help patients live more fulfilling lives. Palliative care is available from day one and should also be provided soon after diagnosis. 

Collaboratively, a multidisciplinary team including palliative care specialist physicians and nurses, dietitians, and psychiatrists, greatly benefits patients. They work in tandem to ensure coordination and communication of patient care plans, management of physical and emotional symptoms, family meetings, and counseling, whether at the patient’s home, nursing home, hospital, or assisted living clinic. 

What makes palliative care so important is its involvement with the numerous factors related to living with a detrimental condition, such as mental health, sleep, loss of ability, and pain. In palliative care, physicians employ a dual strategy of pain evaluation and treatment curated especially for the patient.

Pain is complex and every individual’s threshold is unique to themselves, making assessments difficult. However, because these feelings are connected to other physiological and psychological factors, they can potentially lead to fatigue, stress, and psychiatric illnesses such as depression. Therefore, physicians consider all additional factors and their effects on the patient’s quality of life when they decide on pain treatments. Pain assessment involves detailed evaluations, considering factors such as the origin, intensity, duration, and impact on daily life. This comprehensive assessment supports the development of personalized treatment plans aimed at alleviating the patient’s pain and enhancing comfort.

Following the World Health Organization’s step-care approach, pain management begins with a nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen. An alternative to NSAIDs is acetaminophen, often known as Tylenol.  If the pain gets worse, the physician may prescribe a weak opioid, such as codeine, along with a nonopioid pain reliever. If the pain continues or intensifies, the physician may prescribe a powerful opioid, such as morphine.

Overall, palliative care and pain management are essential elements of healthcare that tend to the physical and emotional burdens of the patient and their family. In the patient’s journey of hardship and resilience, this patient-centered care prioritizes their quality of life, offering comfort and compassion when they most need it.

 

Citations:

“Palliative Care Methods for Controlling Pain.” Johns Hopkins Medicine, 21 Nov. 2023,

for-controlling-pain. Accessed 24 Feb. 2024. 

“Palliative Care.” Center to Advance Palliative Care, www.capc.org/about/palliative-care/.

Accessed 24 Feb. 2024. 

Sholjakova, Marija, et al. “Pain Relief as an Integral Part of the Palliative Care.” National

Center of Biotechnology Information, National Library of Medicine, 15 Apr. 2018,

“Understanding Palliative Care: It’s Not What You Think.” American Lung Association, 1

Dec. 2020, www.lung.org/blog/understanding-palliative-care. Accessed 24 Feb. 2024. 

“What Are Palliative Care and Hospice Care?” National Institute on Aging, U.S. Department

of Health and Human Services, www.nia.nih.gov/health/hospice-and-palliative-

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