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Care of the Imminently Dying

To assist with caring for the imminently dying, please refer to the CDHB End of Life Care Plan.

A diagnosis of dying is very important because it influences medical decision making. If you are not sure if your patient is dying, please refer to the guidelines on the CDHB End of Life Care Plan. Common signs that a patient is approaching the terminal phase are:

When a patient is diagnosed as dying, patient comfort takes priority and increased support for family is needed. This is sometimes referred to as 'comfort cares' and is outlined in more detail on the CDHB End of Life Care Plan.

In This Section

Symptom Management

Retained Airway Secretions (Death Rattle)

Terminal Agitation

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Symptom Management

When the patient reaches the terminal phase, their ability to swallow medication is lessened – subcutaneous administration of medication will therefore be necessary.

Regular medications

PRN medications

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Retained Airway Secretions (Death Rattle)

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Terminal Agitation

See also sections on:

This is also referred to as ‘Terminal Restlessness’ and may require ‘Palliative Sedation’.

Symptoms may include:

Management

Note: If severe and distressing symptoms, a referral to the Palliative Care Team is strongly recommended.

If complete sedation is required, the following drugs, administered parenterally, can be considered:

Newer agents such as olanzapine and risperidone have been found to be useful particularly if extra-pyramidal side effects are encountered but these are only available orally.

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Topic Code: 4145