Agitation and Restlessness in the Final Days: Information for patients and carers

Confusion, restlessness and agitation are common symptoms at the end of life. 

Often the cause is due to a combination of factors, and the first question is whether someone is now in their final days.  Agitation and confusion may be a sign that life is coming to an end and the best approach may be to focus on keeping the person calm so that good memories are created.

Do consider whether physical causes of discomfort are contributing such as pain, nausea, constipation, difficulty passing urine, infection, itching.

Your palliative care team can help to establish if there is a cause which can be easily treated or whether this is part of the dying process.

An approach to care:

  • Try non-medication methods such as reassurance and presence of loved ones, familiar surroundings, objects and music
  • Medication such as haloperidol, levopromazine and midazolam are commonly used to help someone feel calmer
  • Medications are started at the lowest doses
  • Deeper sedation may be needed if agitation worsens
  • The intention is to relieve suffering and symptoms, not to hasten death

Recommended Resources

Marie Curie - Agitation in palliative care

Published 25th November 2022

CNWL Anticipatory medicines - a guide for families

Published 1st July 2020

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24 hour Advice Line Pembridge Hospice
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Pembridge Hospice provides palliative care services and advice to the residents of Brent, Central London, West London and Hammermith and Fulham.

This is a 24 hour, 7 days a week telephone advice line.

Referral form for clinician use only.

 

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Community Palliative Care Team (South) - Royal Trinity

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Royal Trinity Hospice (South) provides advice and visiting palliative care patients of Hammersmith and Fulham, Central London and West London.

They can be contacted 8am -8pm  7 days a week.

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Pembridge Community Palliative Care Team (North)

T. 0208 102 5383 / 0208 102 5000 (out of hours)

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They can be contacted Monday to Friday 8.30am to 5.00pm.

Referral form for clinician use only.

Community Specialist Palliative Care Referral Form V4.1 (DOCX)

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