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?

Joy Berger –

I met Joy at the ADEC conference in Miami in the late spring.  She is bright, energetic, brainy, AND to top that all off, she sings – and she loves to sing.  Her book, ‘Music of the Soul” links with her website of the same name.  Check out the site if you want to understand better how to incorporate music into caregiving or into self care.  Here are the questions that welcome you to the website.

What music voices your core self? Plays out your life’s stories?

What life-losses have you come through? Are you going through?

What music explores the dissonances you feel with your loss?

Moves you to hope, insight and action?

Welcome to your music, with its power to help you be in and move through your personal griefs, and ultimately, to compose life out of your loss.

Bev is a “full of hope” type person, and she brings that hope to her work.  Check her site if music resonates with you.

Joy has just been named the director of education and special projects by the Hospice Education Network in the USA. Good choice folks!


Noah’s Comfort Basket

I have been sick with the flu for the past few days and luckily for me, our five year old grandson Noah decided to be my personal caregiver!

Noah brought me water, a cold cloth, bowl of sliced pears, basket with drawing paper, book, warm winter hat, paintings, and hot pads. He rearranged my blankets, washed my arm, checked in regularly, and blew me a few kisses. In a very loud voice he instructed his little brother to speak to me nicely.

Over the years I have taught about the “Comfort Basket” or the “Basket of Comfort Measures” to nurses, health care workers, family caregivers, and kids in the school communities. I have always enjoyed the concept, but I sure enjoyed being a recipient.

I was impressed by the intuitive wisdom of this kind and loving child. I think I have a new teaching partner!