Pain is a deleterious symptom that frequently occurs at the end of life. The pain can often be severe, contributing to suffering and compromised quality of life. Uncontrolled pain has devastating cons...equences. Pain can interfere with function such as mobility, and can cause psychological distress. Unrelieved pain may also have a negative impact on a person’s survival. Fortunately, management of pain has become a priority for several organizations around the globe. The International Association for Hospice and Palliative Care (IAHPC) and the Worldwide Palliative Care Alliance (WPCA) declared palliative care and pain treatment as a human right. The International Association for the Study of Pain (IASP) named 2009 the Global Year against Cancer Pain. Effective strategies are available to control pain in most people. However, comprehensive assessment and a variety of treatment strategies are necessary to achieve optimal pain control.
This chapter provides an overview of the assessment and management of pain at the end of life. Barriers to adequate pain management will be addressed, along with evidence- based guidelines and practice recommendations. Nurses are on the front line of a person’s care and often facilitate it across the illness trajectory; therefore, they are in an ideal position to assess, manage, and advocate for better pain control.