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Dr. Carlos Gomez, Assistant Professor of Medicine at University of Virginia Medical Center and Medical Director at Hospice of the Piedmont, presented a talk on pain control for patients suffering from end-stage disease on June 19 at Hospice of the Rapidan.
Attending the talk were 15 caregivers, including several nurses who visited from Fauquier Hospital Home Health.
Much of the discussion focused on barriers to effective pain control, such as attitudes and beliefs about opiates, knowledge deficits and clinical practices, and legal regulations which can make physicians reluctant to prescribe medication. Dr. Gomez cited a study which revealed that between 50 to 80 percent of cancer patients do not receive adequate pain control, primarily due to myths surrounding the use of narcotics.
In an effort to dispel these myths, Dr. Gomez emphasized that although patients suffering from end-stage chronic disease must depend on drugs to relieve their pain, they do not become “addicts.” Because they experience a different kind of pain than other patients, clinical techniques for managing their pain must be adjusted accordingly.
For instance, he recommends that opiates be administered regularly in anticipation of pain returning rather than allowing the patient to slip back into pain before requesting the next dose. The use of patient-controlled analgesic pumps has also been effective in keeping patients pain-free.
“It has been well established that patients use less when they control their own meds than those who have to ask for it,” he said. “I think the most important thing is to listen and believe the patient when we tdlk about pain. To make patients prove they are in pain is cruel.”
The staff hopes to bring Dr. Gomez back again this fall to speak with the community about larger issues surrounding end of life care.
Hospice of the Rapidan requests donations of portable cassette tape
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