A common fear of both terminally ill persons and their loved ones is that the dying person will experience great suffering and pain. Many of us are more afraid of dying in pain than of death itself. Pain should be treated as seriously as the disease. Pain can significantly impair the quality of life of individuals, even causing them to give up on living. A plan to manage pain should be as concrete as a plan to manage the disease. In most cases, severe pain and physical discomfort can be managed through effective use of pain management and palliative care (symptom control). This can be accomplished through medical means, such as medications (narcotics and non-narcotics), surgery and nerve blocks, and non-medical means, such as relaxation therapies, biofeedback, massage and good nursing care. Reasons that many terminally ill patients experience a great deal of pain and suffering include:

People with terminal illness may require extremely large doses of narcotics to control their pain. Despite the fact that clinical experience has shown that those who take narcotics for pain management rarely become psychologically addicted, myths about addiction from the use of narcotics are a serious barrier to effective pain management. Fears of causing death are similarly misplaced. It is important to recognize that the disease is causing death, not the medications and procedures used to control pain. Pain management is provided simply to keep the dying person comfortable.

Ask your doctor how he or she will manage any pain result from the illness. Different types of illness might require different approaches. The doctor should have a plan in mind or see that you have access to appropriate pain specialists.

Consider what trade-offs you are willing to make for pain management. Some people would rather endure more pain if it meant they would be more alert. Don't be afraid to let your caregivers know when you are in pain. You should expect to have your pain taken seriously.

Describe your pain as specifically as possible. Let the doctor know how it is affecting your ability to do specific things; when it is better or worse; where it falls on a scale of 1 to 10. When a pain management plan is implemented, follow the plan! The goal of good pain management is to keep you from experiencing pain. Once you are in pain it requires much more medication to bring the pain under control.