Results of the screening indicated that family

Results of the screening indicated that family caregiver concerns included side effects,
fatalism and overdose. At the two-week interval, the intervention group scored better than the
control group with increased knowledge, decreased patient pain and decreased barriers. The
three-month follow up continued the improved outcome within the intervention group. The
results of this study found that the EMPOWER program can assist in managing symptoms and
improve comfort for hospice patients. The authors feel that the EMPOWER program can be a
positive intervention to address barriers to pain management in hospice. However, they feel that
further research is needed to expand the demographics, patient illness, and populations.

Morphine and Hospice 4
This article is consistent with this authors PICO(T) question in that it proposes an
intervention to relieve family concerns regarding pain management beginning with hospice
admission which can lead to better quality of life of the hospice patient.
Oliver, D. P., Wittenberg-Lyles, E., Washington, K., Kruse, R. L., Albright, D. L.,
Baldwin, P. K., . . . Demiris, G. (2013). Hospice caregivers' experiences with pain
management: "I'm not a doctor, and I don't know if I helped her go faster
or.slower". Journal of Pain and Symptom Management, 46 (6), 846-858.
doi:10.1016/j.jpainsymman.2013.02.011
The purpose of this study was to understand the experience of caregivers to hospice
patient’s pain management. The study consisted of interviews of 146 caregivers which resulted
in five themes: administration, side effects, insecurity with assessment, communication and
unrelieved pain. The study concluded that effective planning for pain control needs to include
values and beliefs of patients and families.
This study is important to this writers’ research because it finds many caregivers (37%)
are concerned about side effects of medications (Oliver et al., 2013). Further results indicate that
family caregivers can feel guilt, thinking they overmedicated the patient. The authors of this
study feel that a formal assessment of caregiver beliefs and values can assist staff in planning
care. They conclude that “Early in the admission while the patient is more likely to be able to
communicate coherently, hospice staff would be well served to facilitate family discussions
between caregivers and patients as part of the pain control plan (Oliver et al., 2013).”

Morphine and Hospice 5
Kehl, K. A. (2014). How hospice staff members prepare family caregivers for the patient’s final
days of life: An exploratory study. Palliative Medicine, 29 (2), 128-137.
doi:10.1177/0269216314551320
The goal of this study was to understand the content, strategies and timing of preparing
family caregivers of end of life as well as if information is tailored and who prepares it. The
study interviewed nineteen hospice clinicians to gather the information. Results included
symptoms, implications of symptoms, what to expect next and what to do.
Timing of family preparation was a key component. Many nurses timed the preparation
according to factors such as medication and symptom changes. Many nurses believed that
preparation should begin at admission. With early preparation, families won’t be panicked as the
patient becomes active (Kehl, 2014). It also allows for continual reinforcement of knowledge
shared and time to process the information. This would also apply to pain management options,