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Pain management of cancer when patient can't communicate their pain....

Discussion in 'End of life care' started by Fabbydo, Jan 1, 2016.

  1. Fabbydo

    Fabbydo Registered User

    Jan 21, 2015
    Hello, My mother who's end stage has lost a further stone and a half- she must only weigh about 7 stone now. She does eat a little most days though. GP for her care-home reckons it could be due to cancer although he found nothing when examining her. I don't want to put her through tests,assessments or have her moved anywhere. My main concern is that because she no longer talks, that those caring for her won't realise when she's in pain or acute/chronic discomfort. I can't bear to think of her suffering in pain silently.

    Does anyone have experience of this? Thanks.
  2. TinaT

    TinaT Registered User

    Sep 27, 2006
    #2 TinaT, Jan 1, 2016
    Last edited: Jan 1, 2016
    I have experience of my husband suffering from Lewy Body disease dementia who was later diagnosed with terminal cancer.

    It was difficult at the time of the scan to convince hospital staff I needed to be in his sight whilst they were taking the scan. After they had unsuccessfully tried several times they eventually
    put a vest on me and I stayed in his sight. I don't know how fit your mother might be to go through this procedure in in order to reach a firm diagnosis.

    Unfortunately I had a lot of trouble in his late stages convincing the care home to look through his dementia and to look for pain. Management of pain was barely there despite my arranging for him to be given morphine by his GP . Staff were hit and miss in giving him this pain relief deciding for themselves when they thought he might be in pain.

    I ended up contacting my local hospice and getting a Macmillan Nurse to have him immediately admitted to the hospice where he died some three weeks later.

    I would ask that a pain relief nurse or the district nurse or the GP come and assess your relative with regard to any pain relief which may be needed and keep your eye on whether the care home staff are the appropriate people to administer this because they do not have a qualified nurse on the staff .

    Best wishes TinaTxx
  3. fizzie

    fizzie Registered User

    Jul 20, 2011
    I agree with all the above and most especially contacting the hospice. I would go to your local hospice and ask if the consultant could spare you a few minutes to talk it through - the hospices are usually very helpful and some of them have considerable experience of pain management and dementia.

    I too would consider a scan for a firm diagnosis if the hospice won't get directly involved.

    Really a palliative care team should be involved regardless in my view but this is quite patchy. If you can be very firm about what you want then you may be more successful.

    Thinking of you
  4. Not so Rosy

    Not so Rosy Registered User

    Nov 30, 2013
    Dad has FTL plus AD and is in a care home, he was diagnosed with cancer a few days before Christmas.

    The Palliative Care Team attached to the local hospice contacted me on Weds to introduce themselves and explain what they do. I know there has to be a professional referral in my area. I would be pushing the GP to do that.
  5. Fabbydo

    Fabbydo Registered User

    Jan 21, 2015

    Thanks for everyone's replies. I'll speak to the GP and the Hospice but I really don't want to put Mum through any tests which would need her to go to hospital - and I'm not sure what the point of getting a firm diagnosis would be if no treatment will be given. Other than pain management.
  6. BR_ANA

    BR_ANA Registered User

    Jun 27, 2012
    I would read about 'abbey pain scale' for non verbal symptoms of pain

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