Principles of Symptom Management

Personal Support Workers (Also Known As Health Care Assistants, Health Care Workers) often care for people who require medication or comfort measures to help control their symptoms.

I was asked to explain the principles of symptom management…
Here are a few ideas (not in order of priority!)

Symptom management requires good care planning! The Canadian Hospice Palliative Care Association suggests that assessment, information sharing (with person and family), and decision making (goal setting) should happen BEFORE care planning.
o If you are caring for someone and symptoms are not managed and patient and family express concern about medications or plan of care, it might be because they did not understand the information shared with them when the plans were developed. It could also be that the Health Care Team developed a care plan that was not consistent with what the patient and family wanted. If you hear concerns from patient and family, if person or family are worried about medications or how they are being given, communicate this to the health care team.
• Prevent what is possible to prevent,
o When someone is started on Opioids, they should also be started on laxatives. Monitor bowel movements, and report if constipation occurs.
• Respond to symptoms before they escalate (report pain before it becomes a crisis)
o If pain occurs, do not wait for it to become severe before you record and report it. The same is true with other symptoms, for example, if someone is restless at noon, up and down and up and down… and will not settle, it is very likely that they will be restless and unable to sleep at midnight.
• Medication is one tool to help manage symptoms
o People are often hesitant to take medications. If you hear people express concerns about medications, encourage them to talk with the nurse or physician to discuss their questions, concerns.
• Non-medication comfort measures can decrease discomfort, and can help the medications work more effectively. Consider using items from your “Comfort Basket”

Do you have any suggestions regarding basic principles of symptom management?
Ideas?

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