[Amanda Loots]

#85665

I am quite new in the space of Psycho-social and Spiritual assessment tools.
I know about the FLACC and Wong Baker faces pain scale due to the fact that my daughter that was continuously ill in Primary School with the condition named: Arnold Chiari Malformation of the brain. When she was small it was difficult to really manage her pain scale because she could not yet verbalize properly. Only after 3-4 years of age where she could actually say or show where the pain was, was it more easily and effectively treated. Now that I think of it, I just wonder how could one really determine the severity of pain in an infant or toddler that cannot verbalize/understand good enough?
Do you just go according to crying, temperature, body language or physical signs,or do you stick to the 6-hourly or more medicine giving regimen for prevention, but what if a infant, toddler or child do have continuous pain and you as a care taker or nurse can’t pick up on it? Is Palliative care not about a pain-free, quality end of life? Just my thought.

[Sue Boucher]

#85829

Sorry for not responding to this thread sooner, Amanda, and thank you for sharing your thoughts and asking an important question. Assessing pain severity in a non-verbal child is not easy and the FLACC scale can be very helpful for non-verbal infants and children up to 7 years. But then you need to have healthcare professionals who are trained and who know how to assess the child’s pain using this scale. I would also think that relying on the reporting of a parent or carer who spends a lot of time with the child would be so valuable. Palliative care is most definitely about quality of life and a death which is as peaceful as possible, which includes ensuring good pain management. Unfortunately, this is not always possible, despite a doctor’s very best efforts.

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