Unrelieved pain is the most important symptom to be addressed, when providing support and comfort to an elderly, at the end of life stage. This requires special skills in pain management at the end of life. A survey of hospice nursing home patients showed that 85% patients suffered from moderate to severe pain at the end of life (Bernabei et al. 1998, Pargeon et al. 1999, Fineberg et al. 2006). For this reason a balanced technique of social support, pain control with fewer side effects while keeping patients wishes, is a priority. Optimum pain control with narcotic analgesics, nerve blocks, rhizotomy, implantable devices, and palliative sedation are various ways to alleviate painful dying process. When dealing with an elderly patient for palliative care, patient's wishes, social support of family, friends, or hospice care nurses need to be collaborated in a multi disciplinary pain management protocol.
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