Pain at the end of life is inescapably interwoven with, and often amplified by, multiple levels of emotional and spiritual angst as the inevitability of death looms. Fear, a potent pain magnifier, is the dominant emotion – fear of pain, fear of death, fear of the unknown…..
It is a fact that people at the end of life fear pain even more than they fear death. Sadly, for many dying patients, pain seems like the ultimate torment, and death is its cure. It does not have to be this way, and if you or a loved one is facing death, you have every right to ask that your final days not be consumed by pain.
It is estimated that a maximum of 5% of people who die from terminal illness in South Africa have access to adequate palliative care. Even in hospitals, treatment is far from ideal, because doctors and nurses have seldom had training in palliative care and have little idea of what to do with the patients.
Dying patients are often prey to a host of anxieties about the state of their affairs, about the fate of those who will grieve their loss, and about how their behaviour will be seen, and possibly judged, during their final hours. And of course, there are often deep spiritual and religious questions to address. Did my life have meaning? Will my soul survive my body? Am I at peace with myself, my family, and my friends?
Not least of all these concerns, people at the end of life worry about how their pain will be managed. Will they be under medicated and have to ask, or even beg for relief? Will they be over-medicated and lose consciousness during their precious waning days and hours?
They may even be afraid to complain. If they do, will they be seen as whiners or quitters? If they ask for narcotics, will they be judged by their doctors as drug seeking, drug addicts or even cowardly? Or will their medical care be relegated to comfort measures only, while all efforts to cure their illness are suspended?
I read the post of an amazing woman who is suffering from congenital heart failure. She is in so much pain. I cried when I read her post. http://thedrsays.org/2012/11/08/ She replied to a question whether better pain control was possible….. “there is nothing that will let me participate in life and have relief. so at this point i am going for being lucid over some so-so pain relief. who knows how long before i cave. when the time comes i plan to take advantage of whatever is available to me. just my personal choice right now.”
Vic has received a new lease on life. Vic has 100% better quality of life since her pain is under control. We discovered, through the expertise of a wonderful palliative care team that Vic’s body did not absorb monstrous quantities of morphine! Now she is not only functioning, she is LIVING! Vic is more lucid than she was before.
The pain was killing Vic… Palliative care has given her life.
Being prepared to die is one of the greatest secrets of living. 
George Lincoln Rockwell
Vic's Final Journey 
you are such a dear sweet woman and i want you to know that i do not suffer as your vic does. my liver just chews up and spews out most medications and that is often the case. i have considered palliative care and highly recommend it. for whatever reason i have been able to embrace this friend called pain. it walks with me and has for years. the angina is helped more by none narcotic meds and really when it hits there is little to be done except recline and wait for it to pass. the congestive heart failure causes shortness of breathe and makes it impossible to do much except rest. it is the lack of oxygen being pumped through my organs that causes some of my problems. the liver disease comes with pain much like a charlie horse in your leg except it is in the upper right abdominal quadrant. some of my injuries come from being injured in the line of duty while serving in the military.
as far as all the big questions go i hope that people will talk to their family and professionals for help with those. for me i am not fearful of living with pain or dying. it has been a fabulous life for the most part and i have peace of heart for what is to come and know that while it will be sad for those i leave, they will carry on. that is one of the amazing things about humans and life, we tend to carry on. the joy comes back in when we let it and my hope is that it comes very quickly for my loved ones.
this is great information you have provided and i am sure it will help others.
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This is a wonderful and informative post.Thank you both!
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I am so relieved about efective pain relief for Vic, and dismayed that so few people get the care to which they are entitled so that the end of their lives can be a happy time rather than an anguished one.
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I am so pleased that you get to see Vic looking so much better because the pain is controlled. This is not easy for any of you, but there is no reason for it to be made harder if the effective pain control is available. Best wishes to you all, including the hospice team who are looking after her so well.
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