Navigating and managing total pain Mr. Miller, a 49 year-old man, who lived at home with his wife and son, was admitted to the hospital for severe abdominal pain. He was diagnosed with metastatic colon cancer that had spread to the liver. The hospital physician discharged him with a prescription for four milligrams of hydromorphone to be taken every four hours, however, his pain was not relieved. Mr. Miller’s attending physician was not comfortable administering opioids due to the current opioid crisis and was ultimately hesitant to prescribe pain medication. As a result of these factors, the physician requested hospice involvement. Heart of Hospice evaluated Mr. Miller and was able to discover several factors contributing to the extent of the pain including: • Metastatic disease to the liver • His children’s lack of understanding of the gravity of the situation • His wife’s unawareness of the family business • His sense of failure of family support He was admitted to Heart of Hospice.
Heart of Hospice was able to: • Provide an RN case manager to work with the Medical Director and Attending Physician to alleviate pain by adjusting the medication to include transdermal fetanyle • Provide a Certified Nursing Assistant to relieve the family’s stress by assisting with bathing and dressing • Provide a Chaplain to relieve spiritual pain through music, prayer, and Bible readings • Provide a Social Worker for emotional counseling and end-of-life education for the family. For more information
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