What you should expect

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People respond to pain in very different ways. Cultural factors, age, and gender can all play a role in how people react to the pain they are experiencing. Some people with cancer try to endure their pain alone. However, there are several behaviors, subtle and not-so-subtle, that can help you know that the person you are caring for is in pain. The following behaviors may be indications of unspoken pain:

  • unusual quietness
  • grimacing
  • reluctance to move
  • unwillingness to talk
  • fear of being touched
  • guarding the body (pulling away when you approach the sensitive area)
  • lack of interest in eating
  • inability to concentrate, watch television, or read
  • emotional distance
  • withdrawal from personal interactions or social activities

If the person you are caring for shows any of these symptoms, ask whether he or she is in pain, and let the person know that pain can and should be treated and that you will help them get the pain relief that they deserve.

It is important that you, as a caregiver, understand that the perceptions and attitudes you have about pain can also have a profound effect on the success or failure of a pain control plan. Dealing with pain can be one of the most difficult aspects of caring for a person with cancer. Your values, assumptions, or fears may greatly affect the pain relief your loved one receives, or fails to receive. If you are caring for a person with cancer, you may need to thoroughly evaluate your assumptions about pain, pain medications, and your loved one�s condition. Several common misconceptions can hinder you in helping your loved one obtain optimal pain treatment. Ask yourself the following questions:

  • Are you worried that pain medicines are addictive? The stigma associated with opioid drugs, such as morphine, makes some patients–and even some doctors–shy away from these medications, even though they may be the best pain-relief therapy for the patient.
  • Do you think the patient should tough it out? Some people, especially men, are taught to endure pain and “be brave.” This is the wrong approach. People with cancer should be able to focus on getting well and enjoy their family and friends. They should not have to waste their energy on pain, which can and should be treated.
  • Do your values get in the way? If you find yourself questioning whether your loved one is really feeling pain or suggesting that he or she should hold out a little while longer before taking a medication, stop yourself. Instead, believe the person, validate his or her pain, and offer to assist in obtaining appropriate pain management. How family and friends react to a patient�s expression of pain can affect how and whether they talk about his or her pain.
  • Are you having trouble listening to the patient? Hearing about your loved one�s pain may cause you to become anxious about his or her condition. It may increase your feelings of helplessness. The person in pain may sense your efforts to deny the situation and may then have trouble talking about his or her pain. Recognize that pain does not always mean things are getting worse. Many people think that medicines such as morphine are only for people who are dying. This simply is not so. Morphine is a very effective medicine for many types of cancer pain, regardless of the stage of disease.
  • Do you feel helpless and out of control? Don�t panic. Focus on getting help for your loved one. While help is on the way or a medicine is taking hold, you can provide comfort through massage, music therapy, or just being physically and emotionally responsive to the person. Be aware of, and take care of, your own needs and feelings. Join an online support group, allow yourself to take breaks, and to rely on friends or other family members to take over the caregiving role on occasion. Take advantage of any professional support available to your and your loved.

You and your loved one should be encouraged by the fact that a person�s chances of attaining good pain relief are much better today than they have been in the past. There is a large movement throughout the country to improve pain control in people with cancer, and healthcare professionals are being pressured to take pain management more seriously. For example, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has set new standards for pain assessment and management in all hospitals, home care agencies, long-term care facilities, outpatient clinics, and health plans. These standards require medical institutions to assess pain in all patients, educate healthcare providers and patients about pain management, and establish policies for appropriate pain medication.

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