Pain & symptom relief - these can be caused by:
- a lack of sleeping,
- swallowing difficulties,
- constipation
- and confusion...
Pain and symptom management is an important part of palliative care. Many people rate this as one of the most important issues at this stage of their treatment whether they are at home or in a hospital or other assisted care. You can also have a look at "Palliative Care at Home".
The Minister for Health has announced a new program that will trial new ways to provide palliative care services, delivering the right care at the right time, while also aiming to reduce hospitalisations. The government is funding a pilot program so people nearing the end of their lives receive better care and treatment at home. The $8.3 million program will trial new ways to provide palliative care services, delivering the right care at the right time, while also aiming to reduce hospitalisations.
The Greater Choice for At Home Palliative Care program will be rolled out in ten locations around Australia, enabling people living with a life limiting illness to receive care and treatment services in their home.
The program will be administered through Primary Health Networks across Australia, and will be coordinated with local and state services, as well as aged care providers. The trial runs until June 2020 and interested people and their families, in the trial areas, should contact their GP to discuss joining the program.
The ten Primary Health Networks which have been selected to take part in the trial include:
• Brisbane South;
• Central QLD, Wide Bay and Sunshine Coast;
• Gold Coast;
• South Western Sydney;
• Murrumbidgee;
• Western NSW;
• North Western Melbourne;
• Eastern Melbourne;
• Adelaide, and
• Country WA.
This could include services from a local GP, palliative, hospital and specialist care support, and community and social services – all coordinated to ensure the patient is supported. People will receive the right care at home, tailored to their own need, which will hopefully mean less trips to the hospital to access these services.
Read more here: http://ow.ly/dkWD30iHSb8
Mar 2, 2018
1st May 2018 - Medicare Benefits Schedule
http://www.mbsonline.gov.au/internet/mbsonline/publishing.nsf/Content/news-2018-05-01-latest-news-May
Page last updated: 1 May 2018
More News
News for MBS Online
1 May 2018
Changes to Medicare Benefits Schedule Urgent After-Hours GP Services 1 March 2018 General Questions and Answers:
MBS files (XML, DOC, PDF, ZIP) are now available to download.
Page last updated: 1 May 2018
http://www.health.gov.au/internet/mbsonline/publishing.nsf/Content/downloads
Palliative care specialists liaise and work with all the parties involved to treat and manage pain and symptoms in a coordinated plan. Often a palliative care physician or nurse can suggest alternatives to GPs or specialists that provide a better pain management outcome.
Palliative Care Information Service: Phone 1800 772 273 http://palliativecare.org.au/
Mon - Fri open 9am - 5pm.
This is a free telephone, information and referral service for Queensland residents living with a life limiting illness and those who care for them.
Also provides support with grief and loss in relation to bereavement.
Symptoms may include:
Opioids are a class of medicines taken to help reduce pain. They work on the central nervous system to slow down nerve signals between the brain and the body. This can reduce feelings of pain, but opioids may also produce unwanted effects, ranging from constipation to dangerous slowing down of a person’s breathing. The video aims to help people make an informed decision in partnership with their doctor about whether to start taking an opioid medicine for chronic (ongoing) non-cancer pain.
Consumer resources
NPS MedicineWise Opioid medicines and chronic non-cancer pain
NPS MedicineWise Chronic pain explained
NPS MedicineWise Pain: What is going on?
NPS MedicineWise Medicines for pain relief: what are the options
· Patient Resource – Opioids information video
Patient Resource– Opioid prescribing changes: improving safety, reducing harm - for patients
Pain and pain management:
Most people fear being in pain. Pain is a complex experience made up of many physical and psychological factors. The anticipation that pain is going to get worse may make pain worse. It is difficult to think and make decisions when you are in pain or frightened that pain will return.
The aim of pain control in palliative care is to make you as pain free as far as possible and ensure that your pain is kept under control thereafter.
09 October 2018
5 QUESTIONS TO ASK ABOUT USING OPIOIDS FOR BACK PAIN OR OSTEOARTHRITIS:
Medicines are just a small part of the management of back pain and osteoarthritis. Other options such as exercise, physiotherapy and maintaining a healthy weight help manage the pain. Some medicines like opioids may have a limited role in management of back pain and osteoarthritis but you need to be aware of the risks. Your health professional can discuss the options with you. You have been prescribed an opioid, a type of pain medicine (eg, oxycodone, tramadol, codeine). These medicines may provide a small benefit for some people but have significant side effects and can be addictive. To find out more about the specific opioid medicine you have been prescribed, ask for a Consumer Medicines Information leaflet from your doctor or pharmacist. It’s important to only use opioids for the shortest time and at the lowest dose possible.
NPS MedicineWise
Abbey pain scale
The Abbey Pain Scale is used for people with dementia or who cannot verbalise.
http://www.racgp.org.au/your-practice/guidelines/silverbook/tools/abbey-pain-scale/
You can help your loved one by filling this out. It will give you a greater understanding of just 'what is going on'.
PRESCRIPTION FOR CODEINE REQUIRED IN 2018
Since the 1st of February 2018, all medicines containing codeine are no longer available from pharmacies without a prescription. The reasoning behind this decision has been stated as the potential risk of codeine tolerance, dependence, poisoning and even death (in high doses).
Key points
NPS MedicineWise
Chronic or persistent pain is when pain occurs most days of the week, for at least a three month period. About 1 in 5 Australians suffer from chronic pain and it most commonly occurs in people aged over 45.
Things to do at home to manage your pain:
It is important to always report any new pain to your doctor even if you think you know the cause. If pain is treated early it may be managed with less medication or other treatment. Some useful suggestions to manage pain which you can discuss with your doctor and your local palliative care services include:
Pain Australia has great professional resources to help very Australian access the best possible treatment without delay, to reduce long-term disability, improve work retention rates, and help people and their families live better lives: www.painaustralia.org.au
Information on the range of pain management optiions www.realrelief.org.au
Australian Pain Management Association works with health clinicians, researchers, government and the community to deliver evidence-based pain management services: www.painmanagement.org.au
NPS MedicineWISE has free and evidence-based information on medicines, health conditions and medical tests for both health professionals and consumers:
https://www.nps.org.au/medical-info
Chronic Pain Australia can help you improve your knowledge and understanding about chronic pain across Australia www.chronicpainaustralia.org.au
Fatigue:
Many people find fatigue to be one of the most distressing symptoms they experience when living with a terminal illness. Fatigue can prevent you from enjoying activities or engaging with family and friends.
Fatigue may result from your disease but there may be other factors that can be contributing to how you feel. Medications, treatments, poor eating or sleeping patterns, anxiety, depression, conditions such as anaemia or low grade infection, uncontrolled pain or other symptoms may all contribute to fatigue. These factors should all be considered by your doctor, so that when possible, adjustments can be made to your treatment.
Frustration:
The everyday frustrations of life can be magnified when you have an illness you feel you can’t control. Frustration may lead to anger, or the feeling that you don’t care about anything. These feelings may get in the way of your ability to achieve what you want in life.
Talking is one way of dealing with your frustration. By talking with someone you may be able to work out what is causing your frustration. Often the cause of frustration can be difficult to pinpoint.
If the cause of your frustration is to do with the care or services you are receiving, you might think about what could be managed better. Share your thoughts and ideas with a health care professional who you think could make a difference.
Difficulty breathing:
Difficulty breathing or breathlessness, sometimes called dyspnoea, can be a frightening and debilitating symptom. Often this is a symptom that can be improved with treatment. It is important to discuss any feelings of breathlessness you have with your doctor.
As pain can reduce your ability to take deep breaths and to cough. As a result, secretions may gather in your chest and this can increase your breathlessness. Good pain control is helpful in managing breathlessness.
Difficulty swallowing:
Swallowing is a complicated reflex action that we usually take for granted. Difficulty swallowing, sometimes called dysphagia, may be caused by many things and can cause distress to some people living with a terminal illness.
It is important to tell your doctor if you have any difficulty swallowing and you may be referred to a speech therapist and dietician in you area.
Lack of appetite:
You may have a lack of appetite for many reasons. It may be due to your illness, medicine or treatment, or it may be due to other symptoms such as pain, fatigue, constipation, sore mouth and/or feelings of anxiety, sadness, emptiness or frustration.
If you are not eating, it is important that you speak to your doctor or nurse about this. Some of the causes for lack of appetite can be treated and there are medications available that can stimulate appetite. Weight loss often accompanies living with a terminal illness. However, you should not assume that a lack of appetite cannot be treated.
Have a look at Nutrition in Palliative Care contains additional information and tips on improving appetite.
Constipation:
Constipation may result from the effects of your disease or from the medicines that you are taking. These causes, together with lower activity, eating and drinking less and changes in what you are eating and drinking all make constipation a very common problem.
There are things you can do to prevent constipation but it is important to tell your doctor or nurse if you think you are becoming constipated.
Hope and hopelessness:
Hope is an important ingredient of living a fulfilled life. The hopes we have help us to make plans and to achieve goals.
If you are feeling down or that you have nothing to look forward to, it is important to talk to your doctor or healthcare professional about this. Your doctor will review all your medications and symptoms to ensure these are not the cause of your feelings.
Sometimes, feelings of hopelessness may indicate you are depressed and medication may help. Or, it may indicate you are overwhelmed by your diagnosis and talking with a counsellor may help you to sort out some of things that are contributing to this.
Confusion:
Confusion can be caused by:
https://www.dementia.org.au/files/helpsheets/Helpsheet-DementiaQandA16-PainAndDementia_english.pdf
"As far as we know, the changes in the brain that occur in Alzheimer’s disease and other forms of dementia do not cause pain. However, people with dementia are at increased risk of experiencing pain because they are at increased risk of other things that can cause pain, such as falls, accidents and injuries. Also, older people in general, including those with dementia, are more likely to suffer from a range of medical conditions that can cause pain."
"In the later stages of dementia, many people will lose the ability to verbally report to others that they are in pain. We can still assess whether someone in this situation is in pain, by observing non-verbal signs. In fact, non-verbal signs can be helpful in assessing pain in all stages of dementia.
These signs can be obviously pain-related, but sometimes might just represent a change from normal behaviour. They can include:
• facial grimacing
• gestures that indicate distress
• guarding a particular body part or reluctance to move
• moaning with movement
• limited range of motion or slow movement
• increased heart rate, blood pressure or sweating
• restlessness
• crying or distress
• increased or decreased vocalisations
• withdrawn social behaviour
• lethargy or increased sleep
• disrupted or restless sleep
• decreased appetite (and decreased nutritional intake)
• increased confusion
• anger, aggression, irritability or agitation
Of course, some of these symptoms or changes can be a result of other problems, but pain should always be considered as a potential and treatable cause. It is also important to remember that some people will demonstrate little or no specific behaviour associated with their pain."
- a lack of sleeping,
- swallowing difficulties,
- constipation
- and confusion...
Pain and symptom management is an important part of palliative care. Many people rate this as one of the most important issues at this stage of their treatment whether they are at home or in a hospital or other assisted care. You can also have a look at "Palliative Care at Home".
The Minister for Health has announced a new program that will trial new ways to provide palliative care services, delivering the right care at the right time, while also aiming to reduce hospitalisations. The government is funding a pilot program so people nearing the end of their lives receive better care and treatment at home. The $8.3 million program will trial new ways to provide palliative care services, delivering the right care at the right time, while also aiming to reduce hospitalisations.
The Greater Choice for At Home Palliative Care program will be rolled out in ten locations around Australia, enabling people living with a life limiting illness to receive care and treatment services in their home.
The program will be administered through Primary Health Networks across Australia, and will be coordinated with local and state services, as well as aged care providers. The trial runs until June 2020 and interested people and their families, in the trial areas, should contact their GP to discuss joining the program.
The ten Primary Health Networks which have been selected to take part in the trial include:
• Brisbane South;
• Central QLD, Wide Bay and Sunshine Coast;
• Gold Coast;
• South Western Sydney;
• Murrumbidgee;
• Western NSW;
• North Western Melbourne;
• Eastern Melbourne;
• Adelaide, and
• Country WA.
This could include services from a local GP, palliative, hospital and specialist care support, and community and social services – all coordinated to ensure the patient is supported. People will receive the right care at home, tailored to their own need, which will hopefully mean less trips to the hospital to access these services.
Read more here: http://ow.ly/dkWD30iHSb8
Mar 2, 2018
1st May 2018 - Medicare Benefits Schedule
http://www.mbsonline.gov.au/internet/mbsonline/publishing.nsf/Content/news-2018-05-01-latest-news-May
Page last updated: 1 May 2018
More News
News for MBS Online
1 May 2018
Changes to Medicare Benefits Schedule Urgent After-Hours GP Services 1 March 2018 General Questions and Answers:
MBS files (XML, DOC, PDF, ZIP) are now available to download.
Page last updated: 1 May 2018
http://www.health.gov.au/internet/mbsonline/publishing.nsf/Content/downloads
Palliative care specialists liaise and work with all the parties involved to treat and manage pain and symptoms in a coordinated plan. Often a palliative care physician or nurse can suggest alternatives to GPs or specialists that provide a better pain management outcome.
Palliative Care Information Service: Phone 1800 772 273 http://palliativecare.org.au/
Mon - Fri open 9am - 5pm.
This is a free telephone, information and referral service for Queensland residents living with a life limiting illness and those who care for them.
Also provides support with grief and loss in relation to bereavement.
Symptoms may include:
- Pain
- Fatigue
- Frustration
- Difficulty breathing
- Difficulty swallowing
- Lack of appetite
- Constipation
- Hope and hopelessness
- Confusion
Opioids are a class of medicines taken to help reduce pain. They work on the central nervous system to slow down nerve signals between the brain and the body. This can reduce feelings of pain, but opioids may also produce unwanted effects, ranging from constipation to dangerous slowing down of a person’s breathing. The video aims to help people make an informed decision in partnership with their doctor about whether to start taking an opioid medicine for chronic (ongoing) non-cancer pain.
Consumer resources
NPS MedicineWise Opioid medicines and chronic non-cancer pain
NPS MedicineWise Chronic pain explained
NPS MedicineWise Pain: What is going on?
NPS MedicineWise Medicines for pain relief: what are the options
· Patient Resource – Opioids information video
Patient Resource– Opioid prescribing changes: improving safety, reducing harm - for patients
Pain and pain management:
Most people fear being in pain. Pain is a complex experience made up of many physical and psychological factors. The anticipation that pain is going to get worse may make pain worse. It is difficult to think and make decisions when you are in pain or frightened that pain will return.
The aim of pain control in palliative care is to make you as pain free as far as possible and ensure that your pain is kept under control thereafter.
09 October 2018
5 QUESTIONS TO ASK ABOUT USING OPIOIDS FOR BACK PAIN OR OSTEOARTHRITIS:
Medicines are just a small part of the management of back pain and osteoarthritis. Other options such as exercise, physiotherapy and maintaining a healthy weight help manage the pain. Some medicines like opioids may have a limited role in management of back pain and osteoarthritis but you need to be aware of the risks. Your health professional can discuss the options with you. You have been prescribed an opioid, a type of pain medicine (eg, oxycodone, tramadol, codeine). These medicines may provide a small benefit for some people but have significant side effects and can be addictive. To find out more about the specific opioid medicine you have been prescribed, ask for a Consumer Medicines Information leaflet from your doctor or pharmacist. It’s important to only use opioids for the shortest time and at the lowest dose possible.
NPS MedicineWise
Abbey pain scale
The Abbey Pain Scale is used for people with dementia or who cannot verbalise.
http://www.racgp.org.au/your-practice/guidelines/silverbook/tools/abbey-pain-scale/
You can help your loved one by filling this out. It will give you a greater understanding of just 'what is going on'.
PRESCRIPTION FOR CODEINE REQUIRED IN 2018
Since the 1st of February 2018, all medicines containing codeine are no longer available from pharmacies without a prescription. The reasoning behind this decision has been stated as the potential risk of codeine tolerance, dependence, poisoning and even death (in high doses).
Key points
- Extensive consultation and review of current data has concluded that the risks associated with low-dose codeine medicines outweigh their therapeutic benefit.
- From 1 February 2018, low-dose codeine will no longer be available over the counter in Australia – GPs, pharmacists and pain specialists will be at the forefront of managing this transition.
- This decision gives health professionals and patients opportunities to discuss alternative pain management options and explore more effective and safer approaches to pain.
- This decision will also bring to light patients with dependency issues requiring additional care and specialised management.
NPS MedicineWise
Chronic or persistent pain is when pain occurs most days of the week, for at least a three month period. About 1 in 5 Australians suffer from chronic pain and it most commonly occurs in people aged over 45.
- Call our Medicines Line to speak to a pharmacist: 1300 633 424, Monday to Friday 9am - 5pm AEST
- Report a medicine, medical device or vaccines problem to our Adverse Medicine Events Line: 1300 134 237
Things to do at home to manage your pain:
It is important to always report any new pain to your doctor even if you think you know the cause. If pain is treated early it may be managed with less medication or other treatment. Some useful suggestions to manage pain which you can discuss with your doctor and your local palliative care services include:
- Pain medications – their dose and frequency of use.
- Keeping a pain diary, the use of cold/warm packs, and physical aids.
- Frames (bed cradles) to keep linen and blankets off a painful area.
- Back supports to make sitting more comfortable for you. Ask to speak to a physiotherapist who can advise you on what is available.
- Positioning yourself well can relieve pain.
- Constipation can make discomfort and pain worse and preventing constipation can prevent pain.
Pain Australia has great professional resources to help very Australian access the best possible treatment without delay, to reduce long-term disability, improve work retention rates, and help people and their families live better lives: www.painaustralia.org.au
Information on the range of pain management optiions www.realrelief.org.au
Australian Pain Management Association works with health clinicians, researchers, government and the community to deliver evidence-based pain management services: www.painmanagement.org.au
NPS MedicineWISE has free and evidence-based information on medicines, health conditions and medical tests for both health professionals and consumers:
https://www.nps.org.au/medical-info
Chronic Pain Australia can help you improve your knowledge and understanding about chronic pain across Australia www.chronicpainaustralia.org.au
Fatigue:
Many people find fatigue to be one of the most distressing symptoms they experience when living with a terminal illness. Fatigue can prevent you from enjoying activities or engaging with family and friends.
Fatigue may result from your disease but there may be other factors that can be contributing to how you feel. Medications, treatments, poor eating or sleeping patterns, anxiety, depression, conditions such as anaemia or low grade infection, uncontrolled pain or other symptoms may all contribute to fatigue. These factors should all be considered by your doctor, so that when possible, adjustments can be made to your treatment.
Frustration:
The everyday frustrations of life can be magnified when you have an illness you feel you can’t control. Frustration may lead to anger, or the feeling that you don’t care about anything. These feelings may get in the way of your ability to achieve what you want in life.
Talking is one way of dealing with your frustration. By talking with someone you may be able to work out what is causing your frustration. Often the cause of frustration can be difficult to pinpoint.
If the cause of your frustration is to do with the care or services you are receiving, you might think about what could be managed better. Share your thoughts and ideas with a health care professional who you think could make a difference.
Difficulty breathing:
Difficulty breathing or breathlessness, sometimes called dyspnoea, can be a frightening and debilitating symptom. Often this is a symptom that can be improved with treatment. It is important to discuss any feelings of breathlessness you have with your doctor.
As pain can reduce your ability to take deep breaths and to cough. As a result, secretions may gather in your chest and this can increase your breathlessness. Good pain control is helpful in managing breathlessness.
Difficulty swallowing:
Swallowing is a complicated reflex action that we usually take for granted. Difficulty swallowing, sometimes called dysphagia, may be caused by many things and can cause distress to some people living with a terminal illness.
It is important to tell your doctor if you have any difficulty swallowing and you may be referred to a speech therapist and dietician in you area.
Lack of appetite:
You may have a lack of appetite for many reasons. It may be due to your illness, medicine or treatment, or it may be due to other symptoms such as pain, fatigue, constipation, sore mouth and/or feelings of anxiety, sadness, emptiness or frustration.
If you are not eating, it is important that you speak to your doctor or nurse about this. Some of the causes for lack of appetite can be treated and there are medications available that can stimulate appetite. Weight loss often accompanies living with a terminal illness. However, you should not assume that a lack of appetite cannot be treated.
Have a look at Nutrition in Palliative Care contains additional information and tips on improving appetite.
Constipation:
Constipation may result from the effects of your disease or from the medicines that you are taking. These causes, together with lower activity, eating and drinking less and changes in what you are eating and drinking all make constipation a very common problem.
There are things you can do to prevent constipation but it is important to tell your doctor or nurse if you think you are becoming constipated.
Hope and hopelessness:
Hope is an important ingredient of living a fulfilled life. The hopes we have help us to make plans and to achieve goals.
If you are feeling down or that you have nothing to look forward to, it is important to talk to your doctor or healthcare professional about this. Your doctor will review all your medications and symptoms to ensure these are not the cause of your feelings.
Sometimes, feelings of hopelessness may indicate you are depressed and medication may help. Or, it may indicate you are overwhelmed by your diagnosis and talking with a counsellor may help you to sort out some of things that are contributing to this.
Confusion:
Confusion can be caused by:
- Raised temperature.
- Medications (new or a higher dose).
- Anything that affects the amount of oxygen reaching the brain (not uncommon in heart or lung disease).
- Disease that affects the brain (brain tumour, stroke).
- Pain or other discomfort.
- Chemical imbalances within the body due to the disease or effects of the disease on other organs.
- A combination of the above effects.
https://www.dementia.org.au/files/helpsheets/Helpsheet-DementiaQandA16-PainAndDementia_english.pdf
"As far as we know, the changes in the brain that occur in Alzheimer’s disease and other forms of dementia do not cause pain. However, people with dementia are at increased risk of experiencing pain because they are at increased risk of other things that can cause pain, such as falls, accidents and injuries. Also, older people in general, including those with dementia, are more likely to suffer from a range of medical conditions that can cause pain."
"In the later stages of dementia, many people will lose the ability to verbally report to others that they are in pain. We can still assess whether someone in this situation is in pain, by observing non-verbal signs. In fact, non-verbal signs can be helpful in assessing pain in all stages of dementia.
These signs can be obviously pain-related, but sometimes might just represent a change from normal behaviour. They can include:
• facial grimacing
• gestures that indicate distress
• guarding a particular body part or reluctance to move
• moaning with movement
• limited range of motion or slow movement
• increased heart rate, blood pressure or sweating
• restlessness
• crying or distress
• increased or decreased vocalisations
• withdrawn social behaviour
• lethargy or increased sleep
• disrupted or restless sleep
• decreased appetite (and decreased nutritional intake)
• increased confusion
• anger, aggression, irritability or agitation
Of course, some of these symptoms or changes can be a result of other problems, but pain should always be considered as a potential and treatable cause. It is also important to remember that some people will demonstrate little or no specific behaviour associated with their pain."