One of the fundamental components of hospice care is pain management. By keeping the patient comfortable while they are experiencing pain, it stays true to its mission of providing the highest quality of life to terminally ill patients. As such, one of the most critical evaluations in hospice are pain assessments which are regularly conducted during patient visits. However, patients oftentimes encounter difficulties in verbalizing and describing their pain levels and this is when the following measurement and evaluation tools, often used by hospices, come in handy.
The Wong-Baker Faces Pain Scale, named after its developers Donna Wong and Connie Baker, is a visual rating scale showing six (6) faces from a happy one at 0 which equates to “No Hurt” to a crying face at 10 which equates to “Hurts Worst”. It was initially created for children but has now been widely used in many sectors including hospices due to it being simple and easy for people to use and understand. The assigned discipline will only have to show the faces and their corresponding descriptions and the patients must choose the best one to describe their pain. One limitation however is that the faces represent what the patients feel internally rather than how their faces look externally which may lead to confusion especially in young children.
The FLACC Behavioral Pain Scale is used to screen and assess pain of patients who are unable to communicate their pain, whether because they are non-verbal or just asleep. There are five (5) measurement categories in this scale: Face, Legs, Activity, Cry, and Consolability. Each category is scored from 0–2 which means that for each patient, the total score can be within the range of 0 = Relaxed and Comfortable to 10= Severe Discomfort/Pain. When rating, the assigned discipline usually first observes the patient with the legs and body uncovered. He or she then proceeds to reposition the patient to assess the body for tone and tenseness. For patients who are awake during the observation, the assigned discipline can initiate consoling interventions, as necessary.
The Pain Assessment in Advanced Dementia Scale or what is commonly called as PAINAD is an observational pain assessment tool primarily used for patients who have advanced dementia. Due to their condition, they tend to experience prolonged pain. Like FLACC, the PAINAD measures five (5) items, namely breathing, negative vocalizations, facial expressions, body language, and consolability. Similarly, it also uses a 0–2 rating scale for each item or category, with a total score for each patient ranging from 0=No Pain to 10= Severe Pain. Before scoring, the assigned discipline also observes the patient for five minutes regardless of the condition (i.e., the patient is at rest, doing an activity, etc.)
These pain rating scales and measurement tools are helpful in managing the symptoms of pain in hospice patients. Data Soft Logic, as your Intelligent Care Partner, recognizes that you can focus more on pain management and care delivery with intelligent and reliable symptom documentation tools. Thus, we developed the Symptom Management Pathways in Hospice Centre which stores over 60 of the most common found symptoms in hospice. To find out how this feature can help you, schedule a demo with us now.
Reference:
Powell, Richard, et al. Guide to Pain Management in Low-Resource Settings., 2010.
.png)
