When I worked as a specialist palliative care nurse at a hospice, a 44-year-old lady called Linda with primary progressive MS was referred to us. She had limited mobility, used a wheelchair and complained of severe neuropathic pain in her legs and feet, which was disturbing her sleep and making her feel anxious.
Following a holistic assessment and planning mutually agreed goals, Linda agreed to attend our day therapy unit at the hospice to participate in relaxation and complementary therapy sessions where she learnt skills to help her to relax and learn new coping strategies.
We also changed Linda’s medication and she responded well to amitriptyline, which helped her to sleep, reduced her anxiety and stabbing pain in her legs. We then added pregablin, which Linda felt controlled the burning pain in her feet.
These drugs had previously been prescribed independently and initially at higher doses, which Linda could not tolerate. This regime is not a panacea for all, however, drawing from experience, knowledge and palliative guidelines, we were able to control Linda’s pain.
The hospice physiotherapist and occupational therapist reassessed Linda in her home and were able to make recommendations to improve mobility and independence. We also discussed the notion of future planning, which prompted Linda to set up a Lasting Power of Attorney with our support. Six weeks later Linda told us she felt relaxed, comfortable, more independent and pain free. She agreed to be discharged from the service and was happy to contact us again if required.
I recall Linda saying to us, “If only I had known that the hospice could have helped me earlier.”
Her pain had been problematic for many years. Before hospice input she was beginning to think that she had no option but consider transfer to a nursing home – a decision which Linda felt at her age was inappropriate.
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