Question

An older adult receiving hospice care has dementia as a result of metastasis to the brain. His bone cancer has progressed to an advanced stage. Why might the client fail to request pain medication as needed? The client:

1) Experiences less pain than in earlier stages of cancer.
2) Cannot communicate the character of his pain effectively.
3) Recalls pain at a later time than when it occurs.
4) Relies on caregiver to provide pain relief without asking.

Answer 1

An older adult with dementia in hospice care may not request pain medication due to difficulties in effectively communicating their pain or relying on caregivers to anticipate and manage their pain needs.

Step-by-step explanation:

The reason an older adult receiving hospice care with dementia due to metastasis to the brain and advanced stage bone cancer may fail to request pain medication as needed is likely because they cannot communicate the character of their pain effectively. While it is a common misconception that patients may experience less pain in the later stages of cancer, the more probable explanation here involves cognitive impairment due to their dementia, which can affect their ability to recognize, articulate, or remember their need for pain relief. Furthermore, as hospice care typically provides a support system that includes anticipating a patient’s needs, the individual may rely on the caregiver to administer pain relief without asking, trusting in the expertise and observations of their healthcare team to manage their symptoms.