Signs & Symptoms of Pain at End of Life

If you or your loved one has a terminal illness, managing your pain is a high priority. Pain can be many things to many people; it can be described in many ways. People most naturally tend to think of their physical pain, but pain can also be emotional and spiritual.

Physical pain can be caused by many factors, such as swelling, nerve damage or disease progression. Physical pain may present in many ways:

Signs & Symptoms of Physical Pain

Frowning Grimacing Appetite changes Poor sleeping Fearful expression Teeth grinding Fidgeting

Groaning or moaning Crying Sighing Heavy breathing Decreasing activity Change in gait A loss of function

What is emotional pain?

Emotional pain/suffering can be described as an inner feeling of distress, discomfort or unhappiness. Emotional suffering is very common for people who are seriously ill.

Even for a person who is usually calm and relaxed, as the disease progresses symptoms, such as nervousness, anxiety or confusion, might appear. Feeling frightened, angry, upset or overwhelmed by the condition is common. All kinds of concerns, including health, family, finances or the future, can arise. Feelings of sadness and grief related to losing the ability to be active, as well as drawing closer to the end of life, can occur.

Signs & Symptoms of Emotional Pain:

Forgetfulness Poor concentration Dull senses Lethargy Boredom Low productivity Negative attitude Anxiety

The ‘blues’ Mood swings Anger Bad dreams Irritability Crying spells Nervous laughter Dependency on others

What is spiritual pain?

Some words used to describe pain of the human spirit might include loneliness, feeling separated or abandoned, empty, guilty, fearful or even hopeless. Remember:

These feelings can happen to anyone. When faced with a serious illness, it’s natural to wonder and question at a deep level, regardless of one’s beliefs. This can be a time to explore, listen and be open. It might also be a time to search for meaning, peace, forgiveness or love. This can even be a time of possibility, growth and unexpected joy.

Signs & Symptoms of Spiritual Pain

Emptiness Loss of meaning Doubt Martyrdom Loss of direction Cynicism Apathy Abandonment

Worry Loss of hope Isolation Distrust “No one cares” Guilt Loss of hope “Why is this happening?”

Communicating Pain

Using a consistent system to describe your pain can be helpful; it can help your hospice team determine if your pain changes over time and if you get adequate relief from your pain medicine and other relief measures. Some words you can use to describe pain include:

Sharp Constant Shooting Squeezing

Dull Aching Burning

Nonverbal Indicators of Pain

If your loved one can’t communicate, look for the following signs of discomfort and speak on behalf of your loved one to the care team.

Tense body language Restlessness Strained facial expressions Sad facial expressions Tearfulness Increased resistance/agitation with movement Increased breathing Shortness of breath

Changes in sleeping patterns Loss of appetite Withdrawing from family/others, as well as activities and pastimes Decreased communication Decreased activity because of increased pain with activity Weight gain because of inactivity Rubbing/massaging affected areas Verbalizations or sounds of distress

We always want you to be comfortable. Your Hospice team includes a physician, nurse practitioners, registered nurses, social workers and chaplains who are specially trained to help people with physical, emotional and spiritual pain.

If you or your loved one suffers from a chronic illness and may benefit from a team of professionals who are specially trained to manage pain and provide comfort, please contact us, any time.