Pain Management for Hospice Patients: What to Expect

One of the greatest fears about hospice is: "Will my loved one be in pain?" Effective pain management is a core priority. This guide explains how modern pain management works.

The Hospice Philosophy on Pain

Pain is whatever the patient says it is. Hospice professionals don't question whether pain is real—if someone says they're in pain, they are in pain, and it deserves treatment.

Goals of Hospice Pain Management

Types of Pain

Physical Pain

Cancer pain, non-cancer pain from diseases, nerve pain, bone pain—all respond to appropriate medication and therapies.

Emotional/Psychological Pain

Fear, anxiety, grief, sense of loss—addressed through counseling and sometimes anti-anxiety medication.

Spiritual Pain

Existential concerns addressed through chaplains and counselors.

Medication Options

Opioids

Morphine, fentanyl, and other powerful pain relievers are most effective for moderate to severe pain.

Important: Addiction (seeking drugs for pleasure) is different from physical dependence. Adequate pain control should NOT be prevented by addiction fears.

Non-Opioid Medications

Acetaminophen, NSAIDs, gabapentin for nerve pain, and anti-anxiety medications.

Combination Approach

Most pain is best managed with a combination of medications and non-drug therapies.

Non-Drug Pain Management

Positioning, massage, heat/cold packs, guided imagery, breathing exercises, music therapy, and environmental adjustments all help.

Managing Constipation

Constipation is almost universal with opioid use and must be prevented and treated proactively with stool softeners and laxatives.

Talking to Your Care Team

Ask about medications, side effects, breakthrough pain management, and non-drug options.

Good hospice pain management is an art and science. You don't have to choose between being present and being comfortable.