Pain Management at the End of Life



Types of Pain Management & General Information

When a person is facing the end of life, there is frequently a medical cause. Some medical conditions cause the sufferer a lot of pain. Current medical ethics are now favoring keeping a patient comfortable with the least amount of pain possible versus the prior thinking that a person must not become addicted to pain medication at any cost.

This is certainly an area to talk to the doctor about at the onset of any medical condition that is likely to cause pain. Make sure that the doctor you have chosen thinks the same way the patient thinks about pain management, especially when facing a terminal illness.

The treatment of pain can come in many forms. It can be:

  • acupuncture
  • alternative healing techniques
    such as Reiki, Healing Touch, Touch for Health, and others
  • anesthesiologic approaches such as epidural
  • cognitive behavioral techniques such as meditation and guided imagery
  • cold therapy
  • electrical nerve stimulation
  • heat therapy
  • massage
  • medication
  • nerve stimulation
  • psychological approaches
  • surgical approaches
  • therapeutic exercise

Beth Israel Medical Center offers more information on these methods of pain management.


Many hospitals now recognize the use of alternative healing techniques. Studies conducted by major medical studies have concluded that such techniques provide a great adjunct therapy to traditional medicine.

For example, the National Center for Complementary and Alternative Medicine at the US National Institute of Health (NIH) has studied Reiki as a part of an integrative treatment program using both traditional and alternative therapies. They classify Reiki as a "Biofield Medicine, which involves systems that use subtle energy fields in and around the body for medical purposes". Reiki is a 2,500-year-old hands on system of healing which was introduced to Western cultures in the mid 1900s, and more recently has been adopted by a number of hospitals, and other health care settings. As of 2001 47% of US state nursing boards recognized providing alternative therapies, including Reiki, as being within the scope of nursing practice (if the nurse is qualified in that therapy). They now offer Continuing Education Credits to nurses and practicitioners who take classes to learn these therapies.




Does Your Family Member Have Alzheimer's Disease?

If so, read about the potential for hospice care during the end stage of the disease.




Is Your Family Member a Veteran?

The Veteran's Administration offers palliative care units.




Need Real Life Stories?

The Public Broadcasting System offers real life stories about pain and dying. Before I Die: Medical Care and Personal Choices premiered on April 22, 1997. The program explores the medical, ethical, and social issues surrounding end-of-life care in America today. It was funded by the Robert Wood Johnson Foundation. The first link below is the main page. The others offer quick access to parts of the program.





The following websites offer additional information on "dying well" and living the last days as pain free as possible. Searching the Internet will provide others.

Compassion and Choices
national nonprofit group working to improve care and expand choice at the end of life. Created in 2005 by the unification of Compassion In Dying and End-of Life Choices, Compassion & Choices supports, educates and advocates for choice and care at the end of life. They "work for improved care and expanded options at the end of life, with effective care for every dying person". They "support comprehensive pain control and palliative care, and legal aid in dying if suffering is unbearable".

Death with Dignity National Center
an organization that has helped implement a first-in-the-nation law that allows terminally ill individuals, meeting stringent safeguards, to hasten their own deaths. "DDNC works with leaders in other states considering Oregon-style laws, as legislatures, medical communities and the public come to understand the law's benefits as well as the choice, control and comfort that the law affords."

Dying Well
a longtime palliative care physician and advocate for improved End of Life care and a past president of the American Academy of Hospice and Palliative Medicine, "provides written resources and referrals to organizations, websites and books to empower persons with life threatening illness and their families to live fully". This physician, Dr. Ira Byock, says, "I think it is realistic to hope for a future in which nobody has to die alone and nobody had to die with his pain untreated."



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