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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Community Palliative Care Team - based at Meadow House Hospice
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Community Palliative Care Team - based at Meadow House Hospice

T. 020 8967 5179

W. https://www.lnwh.nhs.uk/meadow-house-hospice/#community-palliative-care-team

The Community Specialist Palliative Care Nurse Team provides advice and visiting to palliative care patients in Ealing and Hounslow. The team are based at Meadow House Hospice.

The team will visit patients with progressive life limiting illness in their own homes. They provide specialist advice around pain and symptom control and support for patients, their families, and carers during the last stages of illness. They also support patients wishing to die at home through coordination with GPs and hospital teams.

The team is comprised of medical consultants, specialist nurses, physiotherapists, occupational therapists, social workers, a bereavement support officer and a patient and carer advocacy worker

The team can be contacted for referrals Monday to Friday 9.00am to 5.00pm.

Between Monday to Friday 5.00pm and 8.30am, the Out of Hours Telephone Advice line 020 8102 5000 takes calls. Weekends and Bank Holidays 5.00pm to 9.00am.

Referral form for clinician use only.

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

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