Different Strokes for Different Folks

Different Strokes for Different Folks


Pain is truly in the eyes of the beholder. It is a subjective experience and varies with each individual. Cecily Saunders, pioneer of the Hospice movement, originated the term, “total pain”, in the late 1960’s. Her approach in diagnosing and treating pain was to consider all aspects of a person’s life, including the physical, emotional, and spiritual. She understood that if people recognized the nature of their pain, it was often easier for them to cope with it.


An individual’s physical pain is often measured on the universal 0-10 pain rating scale. 0 indicates no pain and 10 signifies the worst possible agony. As an alternative, a “faces” pain rating scale was designed primarily for children. It equates facial expressions to differentiate levels of pain. This tool can be helpful for a person who has difficulty speaking due to illness. Another way for either the caregiver to elicit a verbal expression of the person’s pain, or for the person to communicate physical pain is to use adjectives such as sharp, dull, burning, shooting or throbbing.

We also use words to express our emotional state. Happy, sad, mad, and glad are readily recognized sensations. A severe illness and/or a terminal diagnosis often leads to depression, anxiety, or fears such as abandonment by physicians, families, or friends. These can accentuate existing physical pains or even create new ones.

Spiritual pain in not as obvious.

It can sometimes manifest as a sudden onset of restlessness, difficulty finding peace of mind, or even a feeling of being punished. Regardless of the source, this suffering evokes emotions which can exacerbate physical pain. People with terminal illnesses always appreciate an opportunity to tell their story. Sometimes, it helps to alleviate some of the pain they are feeling. Remember, a person’s perception plays a key role in the plan of treatment.

Sue Collins, R.N., Author
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