Patients with serious illness frequently need pain management.  How do hospice teams manage opioids and the challenges that come with them?  There’s often a lack of understanding about how pain medications are used in end of life care. When a patient’s pain is managed, his quality of life is better.  Hospice physicians and nurses are responsible for ensuring the pain is adequately and safely controlled.  Pain affects many aspects of the patient’s life - sleep, mindset, activity tolerance, social interactions, participation in personal care, and appetite.  That’s why everyone on the hospice interdisciplinary team is responsible for assessing whether the patient has pain.  If a patient reports pain, that report goes back to the nurse.  The nurse collaborates with the physician who will order a pain medication appropriate for the patient.  Often those pain meds are opioids.  Those medications can be challenging.  It’s important to know that addiction for a person at the end of life is not a concern, and hospice teams NEVER use medications to accelerate death.  Of course it’s always the patient’s (or caregiver’s) choice to use opioids or even have them in the house.  Hospice professionals should respect those choices and look for other ways to manage the patient’s pain.  When medications are stolen to be sold or for use by someone else besides the patient, that’s called “diversion”.  It’s always important to tell your hospice team if there’s a risk of diversion in a home, including family members with a history of substance use disorder.  You can find more information about managing pain and other symptoms at end of life at theheartofhospice.com.  Check out The Heart of Hospice podcast page for all our episodes with great interviews and personal stories about end of life care with hospice.  Connect with Helen and Jerry by sending an email to [email protected].  We’d love to hear from you to answer your questions and hear your comments.  You are The Heart of Hospice!