The Quick Guide To Non Nursing Pain Assessment For Hospice Patients
Introduction
One of the most important things you can do to help manage pain is talk about it. Asking questions about pain will help the care team determine:
- The type of pain the patient is having
- The treatments that will be most effective
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Pain Assessment Questions
Use these questions to guide your discussions about pain. A good pain assessment helps determine the cause and type of pain the person is having. Understanding the type of pain the person is having, guides treatment and medication recommendations.
- Where is the pain? Pain can be in more than one place. Ask the person to point out all the areas where they have any pain. Which site (location) of pain is the most severe or bothersome?
- What does the pain feel like? Their description of the pain is very important. Your report can help guide the medical care team in discovering which medications or treatments will work best to relieve the pain the person is having. If they have difficulty finding the right words to tell you about their pain, ask if any of the following words might describe their pain: Aching, Searing, Tearing, Burning, Sharp, Throbbing, Cramping, Shooting, Tingling, Cutting, Squeezing, Stinging, Crushing, Stabbing, Pressure
- How intense is the pain? A number scale is frequently used to rate pain. The scale most often used is a 0-10 scale, with 0 being no pain, and 10 being the worst pain you can imagine. Ask the patient to describe pain with words such as: mild, moderate, severe, or worst possible. This helps your team know how well the patient’s treatment plan is working and what changes need to be made.
- How does pain change your activity? Find out how pain is affecting their day-to-day life. For instance, what things are they unable to do because of pain: walking, eating, sleeping, riding in the car, turning over in bed, sitting up, bathing, going to the bathroom, talking?
- What makes the pain better and worse? Some things may make pain increase or decrease. For example, using heat or cold on the place that hurts, sitting or lying in different positions, urinating or moving bowels, and walking may affect the level of pain. Pay attention to anything that can trigger or relieve the discomfort.
- When do you notice pain? When is the pain the worst? Is there a pattern to their pain? When are they most comfortable? Is it worse in the morning when they wake up or during the night? Does movement increase the pain? Is pain worse after eating?
- If currently taking medication for pain, how well is it working? Ask the person to describe how well the treatment in working by using the 0-10 scale. Or, ask if they can tell you how much of the pain is relieved – all, almost all, none, etc. Ask how quickly the medication takes effect and how long it lasts. For instance, does it work well for 2 hours, but wear off before the next dose is scheduled to be taken?
- Are you having any side effects from the medications that you are taking? Most, if not all, side effects from pain medications are preventable or treatable. Encourage the patient to let their care team know if they are having any side effects or problems. Some common side effects that can be managed are: constipation, nausea and vomiting, sleepiness, itching, and confusion.
- Has the pain changed? Pain may change over time. It may get better or worse or feel different. For example, the pain may have been a dull ache at first and has now changed to a burning, tingling feeling. Remind the patient to please report any changes. Changes in pain do not necessarily mean the illness is getting worse.
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