Caring for someone with a life-threatening illness requires a careful and thorough evaluation or "assessment" of their pain and other symptoms. You are the eyes and ears of the doctor and nurses who care for your loved ones.
You will convey important information about your loved one's pain and symptoms to medical staff , so what is the best way to do this? Assessing pain and communicating it to healthcare providers will be one of the most important things you can do while caring for your loved one.
When assessing pain, it is important to understand exactly what pain is. There are several different categories of pain. The pain can be acute (recent) or chronic . It can be localized or it can be diffuse.
There are several ways that pain occurs and these mechanisms lead to different pain sensations. It is important to remember that pain is always what the suffering person talks about, when and where they describe it.
If a person can report their pain, it will be easy to write it down and refer them to their doctor. If they cannot convey what they feel, it may be more difficult to appreciate their pain, but it is still possible. To do this, you need to know the physical signs and symptoms that convey what they are feeling.
A pain assessment is something your healthcare provider will do at every visit or appointment, but you will need to assess your loved one's pain between doctor visits. The following information will be helpful if you can assess the pain yourself.
The power of pain
The first step in evaluating pain is to find out how severe it is at this time. There are tools that can help someone who knows how to communicate describe the severity of their pain.
For adults, this is usually done on a numerical scale of 0-10. Zero would describe no pain and 10 would represent the worst pain imaginable. Ask your loved one to rate their pain somewhere on this scale.
In general, these are the pain levels and their meanings:
- 0 does not hurt.
- 1 to 3 refers to moderate pain.
- 4-6 refers to moderate pain.
- 7-10 refers to severe pain.
There are several different pain rating scales that can be used to facilitate this process. For example , one scale, called the FLACC scale, uses a description of various traits that a person can display to estimate a count from 1 to 10.
These signs include facial appearance, legs (relaxed, tense, or kicking), activity (standing still, twisting, or twisting and wriggling), crying, and comfort .
When we ask young children or non-verbal adults to describe their pain, healthcare providers most often use the Wong-Baker FACES Pain Rating Scale . Recommended for people over 3 years old .
With this scale, you should mark each face using words that describe the intensity of the pain. Have your child choose the face that best describes their pain, or look at the face of a non-verbal adult to decide which aspect of the table best suits your loved one's face.
Acceptable level of pain
Everyone will have their own acceptable level of pain. For some, this may not mean pain, while others have a pain level of 3 on a scale of 0 to 10. It is important to find out what is the acceptable level for the person you are caring for.
If your loved one is happy with pain level 3, you will not want to treat him to the point of sedation so that the pain level is zero. On the other hand, some people try to tolerate pain levels greater than 4, although that pain level often reduces quality of life.
Each time you ask, the location of the pain may be the same. A person with end- stage liver disease can always have pain in the upper right corner of the abdomen. However, it is important to ask why new pain may appear.
If the location is different or new pain develops, be sure to write down this information and share it with your healthcare provider .
Palliative and provocation
Palliative and provocation are important criteria for assessing pain. First, you can ask your loved one what makes their pain easier or "eases" it. They can only be pain relievers . You can change positions or lie on your left side only.
Identifying what reduces pain can not only help you do what helps your loved one, but it can also give the doctor important clues about the cause of the pain, if you don't already know it.
Also ask what makes or causes the pain. Again, this can be movement or lying on a specific side. It can also be food or touch. It will also help you avoid things that cause you discomfort and provide important clues to your doctor.
Assessment of non-verbal signs
As mentioned above, it can be difficult to assess someone's pain if they cannot verbalize it and / or cannot score the FACE scale. There are some signs and symptoms that a person can show if they feel pain that may indicate it:
- Grimace or frown
- Constant or twisting movements in bed
- Moaning, groaning or whining
- Anxiety and excitement
- Appears restless and tense, perhaps lifting legs or kicking
- Protect the area from pain or avoid touching the area.
The more symptoms a person has and the stronger they seem, the better they understand the degree of pain they are experiencing. You can then write your pain as "mild," "moderate," or "severe."
Particularly in advanced patients, underlying psychological and social factors often play a role in the onset of pain. This does not make the experience of pain any less real, but it actually offers a more holistic approach to pain for the intervention to be effective.
For example, patients with advanced cancer often experience painful feelings of fear and isolation. Being open to the emotional background of the suffering of the patient you are caring for is key to providing effective and humane care.
One of the most important things you can do for the one you love is to keep accurate records of your pain and pain relievers. After evaluating your pain, write down its severity and location, and any medications or treatments you give it.
Pay attention to the effectiveness of medications and treatments. Also, write down anything new that you have been told about what makes you feel better or worse. This is a great way to team up with your healthcare professionals to provide the best palliative care possible.
Your pain log does not need to be detailed, but several components will help your healthcare providers better assess both the location and severity of pain, and what treatments are and are not effective.
The following table provides an example of a pain log for someone with abdominal pain:
|Date and Time||Pain level||Pain location||Prescription drug / treatment||Response to treatment|
|November 26 9:00||5/10||upper abdomen||Morphine 10 mg||The pain decreased to 2/10 after 30 minutes.|
|November 26, 13:00||3/10||upper abdomen||warm compress on the stomach||Without changes|
|November 26, 5:00||4/10||headache and upper abdomen||Morphine 10 mg||The pain decreased to 1/10 after 45 minutes.|
Get the word of drug information
By assessing your loved one's pain, you can play a very important role in ensuring that your loved one receives the best possible treatment while experiencing the least amount of pain.
Using a pain scale and keeping a pain diary are good ways to objectify the pain a bit so your healthcare provider knows if additional treatment is needed. Keeping a log can also alert you to changes so you can contact your healthcare providers as soon as possible if necessary.
To conclude, caring for a loved one with a life-threatening illness is perhaps the best thing you can do for another, but it is also very exhausting. As much as possible, remember to take care of their needs. Ask for help and prepare to receive it. Enjoy a few minutes here and there.
You may feel guilty about trying to get your needs met. But remember to take care of yourself if you want your loved one to take the best care of yourself. Remember the advice given by flight attendants before take off. Put on an oxygen mask first.