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The importance of pain and symptom management in palliative care

Ronalda MacDonald, hospital consult nurse with palliative care, prepares a CADD pain pump in the medication room on the An Cala palliative care unit at CB Regional Hospital.

Many people associate, “palliative care” with “end-of-life care,” but that’s only one aspect. Pain and symptom management also play a vital part.

Pain and symptom management is provided to all palliative care patients including those managing a life-limiting illness. A life-limiting illness could be a chronic disease like chronic obstructive pulmonary disease (COPD) or conditions like cancer, ALS, stroke, heart failure and more. Even though a life-limiting disease is progressive, patients can lead active lives for many years after diagnosis.

“When pain and symptom management is involved early in the treatment of life-limiting illness, it makes a positive difference for the patient,” said Lynette Sawchuk, a program manager for palliative care in Eastern Zone. “They can come in and out of the palliative care program as needed. We treat their symptoms and when stabilized, they can be discharged from the program and go back to living their lives.”

In 2008, the An Cala palliative care unit opened at Cape Breton Regional Hospital in Sydney. The short-stay, acute care unit provides pain and symptom management to patients with life-limiting illness, complex palliative care needs and end-of-life patients who do not meet provincial hospice criteria.

Patients on An Cala have access to the range of services provided by the palliative care team including social work, volunteers, music therapy, bereavement services, etc. As well, the Hospice Palliative Care Society of Cape Breton County and Nova Scotia Health are partnering on a refresh of the unit, so it continues to be a place of comfort for patients and their families.

“An Cala is quite peaceful,” said Sawchuk. “It’s a home-like environment that has been well-loved over the past 16 years. It’s important for people to feel like they’re at home and not in a hospital.”

While An Cala has beds for nine patients, at any given time, the palliative care program has about 200 patients in Cape Breton, Victoria and central and northern Inverness counties. For Sawchuk and team, pain and symptom management is key to ensuring the comfort of all palliative patients.

“It’s all about quality of life,” she said. “When you combine well-managed symptoms and good palliative care, there’s greater quality of life for the patient. That means more time for precious moments with loved ones. If pain and symptoms are not managed, you lose those precious moments.”

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