Managing pain and other symptoms is one of the core rolesofpalliative care. In Queensland, people with a life-limiting illness are able to have their palliative care managed by their GP. Where there are other issues, like complex symptoms, Specialist Palliative Care Services work closely with patients, families, and carers to make sure that people feel as comfortable and supported as possible. Good symptom management ensures dignity, reduces distress, and allows people to spend meaningful time with their loved ones.
If you or someone you care for is struggling with pain or other symptoms, speak to your doctor or health care team. You do not have to struggle or go through it alone. If you wish to seek information or support, PalAssist have specially trained Advisors available to listen. Call us on 1800 772 273.
Why symptom management matters
Uncontrolled symptoms, like pain, breathlessness, nausea/ vomiting, fatigue or constipation, can make daily life very difficult. Palliative care aims to relieve suffering and improve quality of life, rather than cure illness. Ideally, it should be introduced at the time of diagnosis of a life-limiting condition. Palliative care is considered a treatment option and can be undertaken at the same time as receiving therapyfrom other specialists. By treating both physical and emotional symptoms early, people are better able to rest, plan and engage in meaningful activities, and feel more supported at the end of life.Good symptom control can also ease carer burdens, reduce hospital admissions, and help people stay at home for longer.
Common symptoms in palliative care
It is important to identify symptoms early, manage what is happening, and so improve quality of life. While every person’s experience is unique and none are sure, several symptoms are commonly seen in advanced illnesses:
- Pain-may be constant, irregular or bought on by certain activities, likecar travel. Pain can range from very mild to severe, at times needing specialised treatment for relief. Pain can be localised to one area or widespread, often determined by the underlying diagnosis, how it is occurringin the body and related factors.
- Breathlessness– also known as dyspnoea, or shortness of breath. It may be frightening and exhausting, both for the person, and for their carers to observe. There can be many causes, such as the life-limiting illness itself, a separate diagnosis, or anxiety. See our Breathlessness factsheet for more information.
- Nausea or vomiting– may be related to some medications, the diagnosis, or various other factors. This can have a considerable impact on quality of life, including appetite and social activities. Further, if severe or prolonged, it may lead to weight loss and nutritional issues. Nausea can also be bought on by worry, anxiety, or the surrounding environment, like certain smells or warm temperature.
- Fatigue– a deep and persistent tiredness, which does not always resolve with rest or sleep. It can be caused by sleep disturbance and indeed also cause sleep issues. It can affect people’s ability to undertake plans, engage meaningfully, and may lead to mood disturbance. You may find more help in our Why am I so tired? factsheet.
- Constipation– may be caused by some medications, lack of mobility, or local disease in the digestive tract. More than just discomfort or being unable to go to the toilet, it can cause further symptoms like incontinence, nausea, or pain. The most effective treatment for constipation is prevention, as discussed in our Bowel Care And Constipation Near The End of Life factsheet.
Other issues may arise, such as depression, anxiety, weight loss, confusion,or swallowing issues. What matters most is that any distressing symptom is raised with the treating team and managed promptly. Often family, carers and loved ones are best placed to notice these changes first.
Approaches to pain relief
Pain is one of the most common symptomsexperienced by people, but also something that concerns many loved ones. It can usually be controlled, especially when managed early. In palliative care, doctors use a combination of tools, including:
- Non-pharmacological strategies, such as heat packs, gentle massage, physiotherapy, and mindfulness techniques.
- Medications-various treatments exist, including paracetamol, anti-inflammatories, and opioids, such as morphine or oxycodone. Choice of medication depends on the cause of the pain, its location, how the drug works and more. When prescribed appropriately, opioids are safe and effective. See our About Morphine factsheet, and speak to your doctor or pharmacist if you have any questions.
- Emotional, psychological, and spiritual support- talking with a counsellor, social worker or religious advisor can reduce stress and the burdens being faced at end of life. There is evidence that these supports play a valuable role in management of pain.
A personalised management plan ensures pain relief is tailored to each person’s needs. Medications may be given consistently for chronic pain (regular intervals to prevent constant pain from returning), with additional doses available for breakthrough pain (as required). Alternatively, you may be prescribed medications on an ‘only as needed’ basis, or to take when something is planned that is expected to cause pain, like repositioning or wound dressings.
Managing breathlessness
Breathlessness can be a distressing symptom, but practical strategies can make a significant difference. These include changing position, using a gentle fan or cool air on the face, and breathing exercises. In some cases, medications like inhalers or oxygen may be prescribed by a doctor to reduce symptoms, depending on the cause. It is important to know that breathlessness can be both a symptom of, but also be caused by, anxiety so relaxation techniques are important in management of breathlessness.
Addressing other symptoms
It is best if you raise your concerns, questions or symptoms with your doctor or care team as they occur. By reporting them early, patients, families and carers can help in the early identification and good management of palliative symptoms, before they become a larger problem.
The role of the wider care team
Palliative care is provided by a multidisciplinary team, including GPs, palliative care physicians, community nurses, allied health staff, pastoral care, and Indigenous support workers. This team-based approach ensures that symptoms are addressed from all approaches, be they physical, emotional, or spiritual in origin. Support can be provided at home, in the hospital, or in dedicated palliative care units and hospices.
You can find local providers through the PalAssist Services Directory, or contact us on 1800 772 273 to chat about your concerns.
When to seek help
If pain or other symptoms are getting worse, do not wait until they become severe or unmanageable. Contact your GP, palliative care team, or chat with the team at PalAssist for about your concerns. Many services may provide after-hours support. PalAssist is available 7am to 7pm, 7 days a week.
It is important to know that palliative care is not about giving up or admitting defeat. It is about living as well as possible, for as long as possible. With the right care, distressing symptoms can be managed, and comfort can be maintained.
