5th January 2024

Neurological

Decreased Alertness

It is common for people in the terminal stages of life to be less easily rousable and spend more time sleeping. There is evidence to suggest that people can still hear even if they are not rousable, and loved ones can therefore be encouraged to continue talking to the patient.

Terminal Agitation

Agitation and restlessness may occur in the terminal phase. It is important to explore possible reversible causes, if appropriate, such as pain, constipation, a full bladder or metabolic disturbances. If no reversible cause can be identified, agitation can be managed with midazolam, haloperidol or levomepromazine. Midazolam may be prescribed as a subcutaneous PRN medication for agitation or anxiety at the very end of life.