UNIT 13

LEARNING OBJECTIVES
Caring for Terminally ill Patients

‣ Talking about feeling

‣ Discussing pain relief
‣ Using a palliative care assessment

LISTENING 1 (Pre Intermediate 3.1)

Talking about Feeling

Judy, the ward nurse is talking to Usha, a patient. Match Judy’s question (1-6) to Usha’s answers (a-f). Listen the
conversation and check your answer.

1 How are your feeling today ? a No, I feel it’s getting worse

2 I’m sorry to hear that. Anything you want to talk about ? b Yes, in the morning. It made me feel
quite sick

3 Oh dear, I see. You don’t think the pain is getting any better c Yes, please. Then I might try to have a
with your treatment. rest.

4 Mm. Did you have radiotherapy yesterday ? d Thank Judy, I’d like that

5 Why don’t I get you some medication for pain and nausea ? e I feel a bit down today

6 Can I get you a cup of tea, too ? f … I’m still in a lot of pain

What other answers could a patient give to the following questions ? Write the possible answers in the table below.
Use the phrases in the box and your own ideas.

A bit better. Have you got the time ? I feel a bit low. I feel a bit sad. I feel awful. I feel OK.
I’m in a bad way. No, not really. No, thanks, I’m not in the mood to talk Not right now, maybe later.
Not too good. Thanks, I’d like that. Yes, it might make me feel better.

How are your feeling today ? Would you like to talk about it ?
READING 1
Medical focus : Pain Relief

Match the types of pain relief (1-6) to the definitions (a-f).

1. Acupuncture a. Medicine taken by mouth or by injection which stops pain

2. Aromatherapy b. Rub or press parts of the body to relieve pain

3. Heat pack c. A machine which gives the patient a continuous dose of medicine

4. Massage d. Use of fine needles to relieve pain

5. Analgesia e. Use of fragrant oils for well-being

6. Syringe driver f. A heated pad which soothes sore muscles

Match the picture (a-f) below to the types of pain relief (1-6) in exercise before.

A ___________________________ B __________________________ C __________________________

D __________________________ E ___________________________ F ______________________________

Match the medical terms (1-4) to their meaning (a-d)

1. Palliative care a. Into the subcutaneous layer under the skin

2. Secondaries b. Extra medication to relieve severe pain

3. Breakthrough dose c. Healthcare which supports a dying patient but does not cure

4. Subcut injection d. Other cancers which grow away from the main tumour
Match these words for types of pain with their descriptions.
1. a throbbing pain a. feels like it is eating you

2. a sharp pain b. travels fast along part of your body

3. a burning pain c. is steady and not to painfull

4. a stabbing pain d. feels like a muscle being squeezed

5. a shooting pain e. feels like something sharp is stuck in to you

6. a dull ache f. comes and goes rhythmically

7. a gnawing pain g. feels like fire

8. a cramping pain h. feels like a lot of sharp points going into you

9. tingling i. is strong and sudden

READING 2

PAIN
Pain is a vital part of our bodies defenses and without it, we could not
survive. Pain warns us what thing are dangerous and so helps us avoid
damage to our body. If the body is already damaged, pain helps with
healing because it makes us protect our injuries. Some babies are born with
a rare condition that makes them unable to feel pain. They do not learn the
lessons that pain ‘teaches’ and as a result suffer many fractures and
infection.
Pain happens when nerve ending in our skin and internal organs send
message through the central nervous system to our brain. The brain itself
cannot feel pain. There are two types of pain, acute pain which lasts a short
time and is removed when the cause is cured and chronic pain which can
last a lifetime and cannot usually be treated. Chronic pain must be
managed using drugs or other methods.
Drugs relieve pain in two ways. Some block the nerves messages and prevent them getting to the brain.
Others change the way the brain receives the messages reducing their effect. Many methods of controlling chronic
pain without drugs have been developed. These include hypnosis, acupuncture, massage and electronic
stimulation of nerves.
Pain sometimes works in strange ways. It is possible for example to suffer a serious injury but not feel any
pain soldiers in battle may not feel pain from wounds until after the battle. The opposite can happen to a patient
who lose a limb can continue to feel pain in the limb long afterwards even though it is missing. This ‘phantom limb’
pain is an example of neuropathic pain caused by damage to the remaining nerves.

Red the article and decide if these statements are true (T) or false (F)
1. People who are born unable to feel pain are unlucky ( )
2. Pain starts in the brain ( )
3. Chronic pain lasts longer than acute pain ( )
4. All drugs which stop pain work directly on the brain ( )
5. ‘Phantom limb’ pain is felt by people who have lost an arm or leg ( )
LISTENING 1 (Pre Intermediate 3.4)
Chris, the ward nurse is handing over to the next shift. Listen to the handover and circle the words in the box that you
hear.

acupuncture analgesia aromatherapy breakthrough medication

heat pack massage palliative care secondaries
sub cut syringe driver

Complete the handover below using words from Listening 1. Listen again and check your answers.
...OK, now we’re up to Jim Sullivan in bed 3. Jim was admitted today for (1) __________________ and pain
control. He’s got cancer of the liver with (2) ____________________ in the spine. He was in quite a lot of
pain when he first arrived. He said the pain in his back is a stabbing pain. He also has pain in the liver area
and he describes this as an aching pain. Jim was taking regular (3) ___________________ at home but it’s
not enough now. He rated the pain as 9 out of 10 when I spoke to him. Doctor Donnely saw Jim this
morning and ordered a (4) ____________________ . I explained to Jim that this will give him a small
amount of painkiller medication continuously. The (5) ______________________ cannula for the syringe
driver has been inserted into his abdomen. I checked Jim just before handover and he says the pain level is
much better now. Jim’s had one injection of (6) ______________________ this morning. He also finds that
a (7) ______________________ on his back help a lot.

READING 2
Read the article about the GT LightTouchTM. Are these statements True (T) or False (F) ?

1. The GT LightTouchTM is a machine which is used to check for cancer of the cervix.
2. The new machine has not been tested yet.
3. The new technology is more accurate than the previous cervical test.
4. Cancer of the cervix is a serious problem for all women.
LISTENING 2 (Pre Intermediate 3.5)
Karin the ward nurse, is using a Palliative Care Pain Assessment with Wilf, a patient. Listen to the conversation and
answer the following question.

1. Why does Karin use the Pain Assessment chart ? 


_______________________________________________________
2. How many pain areas does Wilf have ? 

_______________________________________________________
3. When is Wilf shoulder pain worst ? 

_______________________________________________________
4. Which pain is the most severe ? 

_______________________________________________________
5. When does Wilf’s leg ulcer hurt ?
_______________________________________________________
 Grammar Practice

Complete exercises below. These exercises practice the following grammar points:
●  present simple and present continuous 


Complete the sentences by writing the verb in brackets in the present continuous.

1. The phone is __________________ (ring). Can you get it, please?

2. I’m afraid she _________________ (speak) with the doctor at the moment.
3. My hands _________________ (hurt) worse and worse lately.
4. Mrs Jones ___________________ (feel) much better today.
5. You _____________________ (take) your medication every day, aren’t you?
6. The pain ___________________ (get) worse.
7. My husband __________________ (not / cope) well with my illness.
8. I’m very worried about her. She ___________________ (not / eat) at the moment.
9. You ____________________ (not / sleep) as well at the moment. Is that correct?
10. This buzzer _____________________ (not / work). Can you fix it for me, please?