Understanding and managing total pain
Pain is often thought to merely be a physical feeling; however, pain can extend beyond the physical realm. Scholar Dame Cicely Saunders coined the term “total pain” to describe the psychological, social, spiritual and physical elements of pain. Managing total pain at the endof-life is crucial to provide patients with the best possible end-of life care.
Psychological Pain
Social Pain
Spiritual Pain
Pain felt as an individual navigates beliefs centralized around the acceptance of mortality Hospice can: - Provide a Chaplain - Provide a Social Worker - Educate the patient and family
Pain that is caused from changing roles within an individual’s social group (family, friends, etc.) Hospice can: - Provide a Social Worker - Provide the family with emotional support - Educate the family
Social
Total Pain
Spiritual
Physical
Psychological
Psychological pain describes an individual’s overall mental well-being (depression, etc.) Hospice can: - Provide a Social Worker - Provide a Chaplain - Provide support for the family - Recognize & manage signs and symptoms of mental distress
Physical Pain
Pain that is physically “felt” and often caused by a physical illness Hospice can: - Provide a RN case manager - Provide a Certified Nursing Assistant - Provide a Hospice Physician to visit and oversee patient’s pain management - Manage pain through care and appropriate medication -
Source: Goebel, Joy R., Lynn V. Doering, Karl A. Lorenz, Sally L. Maliski, Adeline M. Nyamathi, and Lorraine S. Evangelista. “Caring for special populations: total pain theory in advanced heart failure: applications to research and practice.” In Nursing forum, vol. 44, no. 3, pp. 175-185. Malden, USA: Blackwell Publishing Inc, 2009.
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