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Starts at $9.98 per contact hour
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8 hours $7.98
12 hours $6.98
20 hours $5.98
30 hours $4.98

Pain Treatment at the End of Life

2.0 Contact Hours
Target Audience: Nurses, healthcare professionals, and interested individuals
Purpose/Goal: The outcome of this course is for the learner to describe key concepts related to effective pain management at the end of life, including the roles of the caregiver, hospice provider, and palliative-care provider.
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Regardless of the cause, pain is a common symptom in clients who are near death. Healthcare providers must understand the tremendous implications of pain and pain symptoms and prioritize the assessment and optimal treatment of pain in clients near the end of life. They must be knowledgeable about alternative routes for analgesia and analgesic dosing and understand when to make referrals to palliative care providers and/or specialists to assist in the compassionate and effective management of pain during this time.

Upon completion of the course, you will be able to do the following:

  • Identify the types of pain found in clients near death.
  • Describe the appropriate types of pain relief for clients near death.
  • Explain why nonopiod and/or opioid analgesics would be used near death.
  • Discuss how to determine which route of medication administration is appropriate for the terminally ill client.
  • Describe the role of family caregivers in providing pain management at the end of life.
  • Identify symptoms of distress at the end of life.
  • Identify symptoms of pain at the end of life.
  • Describe the role of hospice and palliative care providers at the end of life.
  • Explain the use of a symptom relief kit.
  • Identify barriers and facilitating factors for treating the symptoms of pain at the end of life.

Unrelieved pain is one of the most common causes of somatic, psychological, and spiritual distress in the months, weeks, and days before death. In addition to wanting to preserve as much quality of life as possible, most patients at the end of life prefer to die elsewhere rather than the hospital. Achieving this goal requires adequate pain control. The relief of pain at the end of life is a priority for patients, family members, caregivers, and healthcare professionals, yet it continues to be under recognized and undertreated or untreated (Brennan, Carr, & Cousins, 2007; Reynolds, Drew, & Dunwoody, 2013; Groninger & Vijayan, 2014; Ripamonti, Santini, Maranzano, Berti, & Roila, 2013).

In the poorest and most socially dysfunctional developing nations, pain at the end of life is widely ignored despite the widespread suffering from causes such as human immunodeficiency virus (HIV), acquired immune deficiency syndrome (AIDS), poverty, oppression, violence, and war and its aftermath (such as land mines). In developing countries, the gap between recognizing the importance of pain management at the end of life and effectively treating it has resulted in numerous declarations underlining the fact that pain is being inadequately addressed for many cultural, attitudinal, educational, political, religious, and logistical reasons. Yet the problem of unrelieved or inadequately treated pain persists, resulting in enormous physiological, psychological, economic, and social consequences for patients, families, and communities (Brennan, Carr, & Cousins, 2007).

Failure to achieve effective pain relief has profound outcomes, including tremendous suffering for patients, a sense of failure by family and caregivers, and distress among professionals who understand that the goal of a peaceful death is based on a foundation of effective pain relief (Ferrell, 2010).

The field of pain management has advanced tremendously over the past 20 years and is supported by evidence-based guidelines for practice. Thus, effective and compassionate pain relief at the end of life should no longer be an issue of concern. When healthcare providers are knowledgeable and centrally involved in patient education about medications, the management of adverse side effects, nonpharmacologic pain management options, and the evaluation of the patient’s response to pain relief options, everyone benefits (Ferrell, 2010).

The careful assessment of pain is the vital first step in effectively managing pain at the end of life (Ripamonti, et al., 2013). This assessment is essential at every stage of the patient’s disease to determine the underlying cause(s) of pain and select appropriate pain relief treatments. In end-stage disease, it is a common mistake to assume that a comprehensive pain assessment is no longer needed and that worsening pain is due only to the advancement of the disease. This is not true, and ongoing assessments are critical to providing the patient with effective pain relief (Ferrell, 2010; Groninger & Vijayan, 2014).

Clients with advanced cancer are more likely to be assessed and treated for potential pain as they near death than are clients with a history of nonmalignant pain. Yet, it is imperative that all clients near death are assessed and treated for pain, regardless of diagnosis.

Complete the course post exam (CE Test) with a score of 80% or greater. Complete all fields of the course evaluation form. Certificate of Completion is provided once the course post exam is passed per criteria above.

  • American Board of Managed Care Nursing
  • ANCC - American Nurses Credentialing Center
  • AOTA - American Occupational Therapy Association
  • ASWB - Association of Social Work Boards
  • California Board of Registered Nursing
  • California Department of Health, Aid, and Technician Certification Section
  • District of Columbia Board of Nursing
  • Florida Board of Nursing
  • Florida Board of Nursing - Certified Nursing Assistants
  • Florida Board of Respiratory Care
  • Florida Council of Dietetics and Nutrition
  • Florida Council of Licensed Midwifery
  • NAADAC - The National Association of Alcohol and Drug Abuse Counselors
  • Florida Board of Massage Therapists
  • NCBTMB -National Certification Board for Therapeutic Massage & Bodywork
  • California Board of Behavioral Sciences


Practice Level:


Content Focus:

Domain of OT

Course Expires:

June 01, 2020

  • Cyndie Koopsen, RN, BSN, MBA, HNB-BC, RN-BC, HWNC-BC
  • Caroline Young, MPH
Jurisdictional Requirements:

Continuing education (CE) licensing requirements vary by jurisdiction, are not well defined, and may change. These CE requirements may vary in terms of the number of hours required to the types of courses that must be taken. ALLEGRA Learning Solutions, LLC recommends you contact your licensing board or accrediting organization for the latest continuing education requirements of your state or territory. Compliance with CE requirements is the responsibility of the individual health care provider. Health care providers must understand the CE requirements in their jurisdictions, and be sure they are up-to-date on any rule changes that affect their license. For further information, please see our Accreditation Information.

Accommodations for Disabilities:

Every effort will be made to accommodate your special needs. To request accommodations, please contact us.

Conflicts of Interest and Relevant Financial Relationships:

The authors/planning committee members have no conflicts of interests or relevant financial relationships to declare relevant to this activity.

Commercial Support:

No commercial support has been received for this activity.

Non-endorsement of products:

Accreditation refers to recognition of continuing nursing education only and does not imply ALLEGRA Learning Solutions, LLC approval or endorsement of any commercial product.

Off-label Use of Products:

Sections of this course will discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.