{"ref":"LA-HSP-PAIN-01","title":"Pain and Symptom Management and Care of the Actively Dying Patient","category":"Hospice care","summary":"Sets out how the Agency assesses and manages pain and other symptoms, from the registered nurse assessment with emphasis on pain and symptom control (LAC 48:I §8219.C.1) through the plan of care interventions, reassessment after treatment (Agency clinical standards), uncontrolled symptoms and periods of crisis, opioid safety, the patient’s right to accept or refuse treatment, and care of the actively dying patient and family.","inShort":["Ask about pain and other symptoms at every visit, using the same scale each time; use a behavior scale if the patient cannot tell you.","Check whether an extra dose worked: about an hour after a dose by mouth, 15 to 30 minutes after an injection.","If pain or another symptom is not controlled, call the practitioner the same day, or at once if it is severe.","Start a bowel plan with opioids and teach the family the signs of too much medicine.","Families may call us any time on (225) 555-0199; when death is near, explain what to expect and who to call."],"primaryCitation":"LAC 48:I §8219.C.1","citations":["LAC 48:I §8201 (Palliative Care; Period of Crisis; Continuous Home Care)","LAC 48:I §8219.C.1","LAC 48:I §8221.A.3.a","LAC 48:I §8221.B","LAC 48:I §8217.I.1.b.i","LAC 48:I §8231.A.4-5","LAC 48:I §8235.B.2"],"federalCitations":["42 CFR §418.52(c)(1)","42 CFR §418.54(c)","42 CFR §418.54(e)","42 CFR §418.56(c)(1)","42 CFR §418.204(a)"],"surveyorAsks":["How do you assess pain in a patient who cannot tell you about it?","Show me this patient’s pain scores and what was done when the pain was not controlled."],"forms":[],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (LAC 48:I §8219.C.1)","5. Assessment","6. Planning Care","7. Reassessment After Treatment","8. Common Symptoms","9. Uncontrolled Symptoms and Periods of Crisis","10. Opioid Safety","11. When a Patient Declines Treatment","12. Care of the Actively Dying Patient","13. Responsibilities","14. Records and Compliance Monitoring","15. Staff Training","16. References","17. Related Policies and Forms","18. Approval","19. Revision History"],"version":"1.0","sample":false,"pack":"la-hospice","state":"Louisiana","service":"Hospice","guides":[{"path":"/guides/hospice-policies/","h1":"What policies are required for hospice?"},{"path":"/guides/hospice-conditions-of-participation/","h1":"Hospice Conditions of Participation: which policies each one needs"}],"agency":{"name":"Sample Agency","legalName":"Sample Agency, LLC","logo":null}}