Copyright © Diane Gainey -

"There is a silence into which the world cannot intrude.
There is an ancient peace you carry in your heart and have not lost."


Whole Patient Pain Assessment

Physical What is the likely cause of this pain in this patient at this time?
What structural or functional abnormality would cause this pain pattern?
Psychological How is the patient coping with the pain?
How much anxiety or depression is present?
What are the patient's ideas, concerns or expectations about pain and its management in this situation?
What information do they need?
Social How is the pain affecting the family?
How much family anxiety is present?
What are the family's ideas, concerns and expectations? (These may differ from the patient's)
How have family dynamics been affected by this illness?
How is the pain limiting the usual role(s)?
Spiritual How much distress or suffering is this patient experiencing?
What does the pain mean to them?
What does the illness mean to them?
What sustains them in difficult times?

Site of pain:
Using a simple body chart to document location and intensity of pain(s) at first assessment can form a useful aide memoir and be valuable in monitoring the effectiveness of interventions, particularly when dealing with mulitple pains.

Duration of pain:
Should be recorded. Is it episodic or continuous? Was there a clear trigger e.g. a fall or a certain movement?

Intensity of pain:
A simple measure of pain intensity is to ask the patient 'What does the pain stop you doing?' and 'Does the pain disturb your sleep?' Various pain intensity scales are available and can be useful where staff and patients are well trained. These grade pain intensity on numerical or verbal visual analogue scales.

© Dr. Eileen Palmer, Dr John Howarth Palliative Care for the Primary Health Care Team (2005) Quay Books ISBN 1856422291
Palliative Care Pain Pack 1. Dr Eileen Palmer 2008

Important News

Important Changes in Cumbria Palliative Care Prescribing Practice

Cumbria is changing practice, from 1st April 2011.

The Area Prescribing Committee has recommended the following changes:

  • All strong opioids are to be prescribed by brand name
  • "Just in Case" prescribing is to be encouraged and promoted
  • Morphine is to replace diamorphine as the subcutaneous injectable strong opioid of choice for palliative care patients in Cumbria


Read More

North Cumbria Pallative Care website

The award winning North Cumbria Palliative Care website continues to receive around 30,000 page views a year. This is 82 page views every single day of the year, 2,500 hits every month, without any publicity or advertising program.


Read More