Pain and Symptom Management at End of Life

This flashcard set covers essential terminology, medications, and concepts regarding hospice care and symptom management as presented by Jason Libby.

Jason Libby

The Nurse Practitioner Supervisor for Hospice of Southern Maine who is certified in hospice and palliative care.

Gosnell House

An inpatient facility in Scarborough, Maine, that provides hospital-level hospice care and respite services for patients with complex symptom management needs.

Transitioning

The period at the end of life described as having one foot in this world and one foot in the next, which can be troublesome due to untreated discomfort.

Pain

A personalized experience defined in hospice as whatever the individual tells the provider it is.

Oxycodone

A pain medication that is $50\%$ more potent than morphine milligram per milligram but has a more troublesome side effect profile.

Methadone

A pain medication often associated with recovery from drug abuse that is effective for managing complex pain issues.

Ativan and Valium

Short-acting medications used to calm the evolutionary fight-or-flight response associated with anxiety and restlessness.

Haldol

An old-school anti-psychotic medication used in hospice to manage nausea and agitated delirium, regardless of the underlying cause.

Dyspnea

The clinical term for the awareness of shortness of breath or the sensation of air hunger.

Macy catheter

A thin tube placed into the rectum to administer medications that are quickly absorbed systemically through the surrounding blood vessels.

Phenobarbital

A sedative-hypnotic medication used as a barrier between a patient's perception and their physical self to treat persistent whole-body suffering or existential pain.

Death rattle

A noise produced when a small amount of fluid accumulates in the back of the throat and the patient breathes past it during the active dying phase.

Adjuvant medications

Non-narcotic substances like Tylenol, Motrin, or steroids (such as Dexamethasone) that can be used alongside narcotics to improve pain relief.

Hyoscine, Robinul, and Atropine

Specific medications used in hospice care to help dry up oral secretions and upper airway congestion.

Curative Treatment

Any medical intervention aimed at fixing a disease (such as chemotherapy or organ transplants) which generally disqualifies a patient from receiving hospice care.