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Symptom Management

Find peace of mind by understanding what your loved one’s symptoms mean, what could be the cause and how to help. At Emmanuel Hospice, our care team is ready to assist during critical moments. Led by a medical director who is certified in hospice and palliative care medicine, our team of specialists embraces the hospice philosophy of comfort versus care.

Trouble Breathing

Defined as breathlessness, shortness of breath or the feeling of not being able to catch your breath. Also described as chest tightness, working to breathe or breathing hard.

  • Diseases which may affect heart, lungs, airway and muscles 
  • Infections such as pneumonia 
  • Fluid overload 
  • Anxiety and/or fear

Medications 

Different types of medications can be used to help trouble breathing. These may include: Inhalers, steroids, oxygen, heart medications, pain medications (Morphine, etc.), anti-anxiety medications, diuretics (water pills) 

Non-Medication 

Pursed lip breathing, abdominal breathing, postural position: sitting upright (head of bed up) and leaning forward, a bedside fan or open window, creating a calming environment, calming activities and allowing time for rest 

Complementary Services 

  • Massage 
  • Music 
  • Acupuncture/Acupressure

  • Anytime there are questions or concerns 
  • If experiencing distress 
  • New or worsening difficulty breathing 
  • Medications are not effective

Constipation

Constipation occurs when bowel movements are less often than usual, when a person is having increased difficulty moving their bowels or when experiencing pain/discomfort with bowel movements.

  • Medications, most often pain medications 
  • Certain diseases 
  • Bowel obstructions 
  • Decreased intake of food and fluids 
  • Decreased physical movement

 Medications

  • Stool softeners 
  • Laxatives 
  • Suppositories 
  • Fiber 

Non-Medication 

  • Taking measures to prevent constipation (diet, fluid intake, medications) 
  • Fluids (water), fruit juice, soup, frozen treats, fruits and vegetables 
  • Physical movement when appropriate 
  • Proper positioning while having a bowel movement

  • Anytime there are questions or concerns 
  • Bowel movements are occurring less often than usual 
  • Experiencing new or worsening symptoms 
  • Prescribed medications are not helping 
  • If experiencing distress

Pain

Pain can appear as restlessness, sleeplessness, discomfort, behavior changes (irritability, withdrawal), tearfulness, guarding of a body part, negative comments, moaning or calling out and facial grimacing or a furrowed brow.

How pain is experienced helps identify ways to manage pain. 

  • Nerve pain can be described as burning, numbness, “pins and needles” 
  • Skin, muscle, bone and joint pain can be described as dull, aching, throbbing 
  • Internal tissue and organ pain can be described as cramping, pressure, deep pain 
  • Pain can originate from emotional or spiritual distress, and may be difficult to describe

Medications 

Different types of medications can be used to manage pain as prescribed by the physician. These may include: 

  • Over-the-Counter Medications 
  • Prescribed medications may include: opioids (Norco, Morphine, etc.), anti-anxiety or antidepressant medications, anti-seizure medications, steroids 

Non-Medication 

Positioning for comfort, relaxation or distraction (ex. virtual reality), heat or cold, deep breathing, relaxing environment (lighting, music, blankets & pillows, etc.), emotional and spiritual support 

 

Complementary Services 

Massage therapy, music therapy, essential oils, acupuncture/acupressure, pet visitors

  • Anytime there are questions or concerns 
  • Experiencing new or worsening symptoms 
  • Prescribed medications are no longer helping
  • If experiencing distress

Anxiety & Sadness

Anxiety causes feelings of stress, worry or fear that can show up as physical symptoms such as difficulty breathing, tightness in your chest and/or muscles, fast heart rate and sweating/ clamminess. Sadness can cause feelings of loss, despair, grief, helplessness, sorrow and disappointment.

  • Discomfort from symptoms such as pain, trouble breathing, and nausea 
  • Anxiety and sadness are natural emotional responses to terminal illness and uncertainty. While normal, these feelings can significantly impact quality of life. When these symptoms are shared with us, we can develop a plan together.

 Medications

Different types of prescribed medication can be used and may include: 

  • Anti-anxiety medications 
  • Antidepressant medications 

Non-Medication 

Deep breathing, emotional support, relaxing environment (lighting, music, blankets & pillows, etc.), decreased stimulation, treatment of symptoms causing anxiety (pain, nausea, etc.) 

 

Complementary Services 

  • Massage Therapy 
  • Music Therapy 
  • Essential Oils 
  • Acupuncture/Acupressure 
  • Journaling 
  • Virtual Reality

  • Anytime there are questions or concerns 
  • Experiencing new or worsening symptoms 
  • Prescribed medications are not helping 
  • If experiencing distress

Heart Failure

Heart Failure

Worsening heart failure can present as difficulty breathing, persistent cough, increased swelling (particularly in legs, ankles and abdomen), weight gain, loss of appetite and nausea, confusion and/or lack of energy.

Medications 

Different types of medications can be used to help worsening heart failure as prescribed by the physician. 

These may include: 

Diuretics, heart medications, anti-nausea medications, anti-anxiety medications, oxygen, pain medications (Morphine, etc.) 

 

Non-Medication 

Deep breathing, positioning for comfort, postural position: sitting upright (head of bed up) and leaning forward, a bedside fan or open window, relaxation or distraction (ex. virtual reality), relaxing environment (lighting, music, blankets & pillows, etc.), adequate time for rest, dietary changes, emotional and spiritual support 

 

Complementary Services 

Massage therapy, music therapy, essential oils, acupuncture/ acupressure, pet visitors, virtual reality 

 

Patients who are participants in the Emmanuel Hospice Heart and Soul Program may refer to the appendix titled, “My Action Plan” for personalized symptom management information.

  • Anytime there are questions or concerns 
  • Experiencing new or worsening symptoms (pain, nausea, etc.) 
  • Increased confusion or changes in behavior 
  • Changes in weight 
  • Skin breakdown (can occur with increased swelling) 
  • Prescribed medications are no longer helping 
  • If experiencing distress 

It may be time to consider modifying or discontinuing heart medications when there are changes to: 

  • Fluid intake 
  • Blood pressure and heart rate (may experience dizziness or lightheadedness) 
  • Ability to swallow 
  • Ability to perform basic needs (standing, walking to bathroom) 
  • Goals of care (side effects may outweigh benefits) 

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