Identifying Changes in Characteristics and Intensity of Pain of the Actively Dying
When the patient is actively dying, the characteristics of the pain may change and the pain intensity may increase or decrease. Doses of medication should be adjusted based on principles of pain and symptom management.
Many family members and even health care professionals are concerned about “Giving the last dose” for fear that that dose will cause or hasten the death. If the basic principles of pain control have been followed, the pain medication dose will not cause the death. Rather, it is the disease process that will be the cause of death.
Anticipating this concern and educating family members prior to the death can decrease complications of bereavement following the death. Questioning the alternative of dying in pain and extending suffering is one way of approaching this option with families and professional caregivers.
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