Bed Sores and Hospice Care

In the U.S., hospice care seems to have become synonymous with end of life care.  Many people choose hospice care to spend their last days at home, and the hospice care team provides care and support to the patient and the patient's loved ones.  Research data seems to support the benefits of hospice care and the improved quality of life during this period.

Pain relief and palliative care are primary goals during hospice.  With respect to bed sores, which are common among hospice care patients, should pharmacological pain relief be the primary method?  Pressure relief on bed sores, using products proven to lower pressures for bed-bound patients at various inclination levels (for eating, watching TV, reading, etc.), would achieve similar levels of pain relief for patients while allowing them to remain "clear-headed" to naturally interact with their loved ones.  If quality of life is one of the primary goals during one's last days, shouldn't the patients be minimally impacted by mind-altering pain killers (unless absolutely necessary systemically)?