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 Michael Sobell Hospice
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24 hour Advice Line Michael Sobell Hospice

T. 0203 824 1268

Offers support and advice on palliative care issues to GPs, Care Homes, District Nurses and hospital doctors.

It is also an Advice Line for patients and families who live in Hillingdon and need advice on any aspect of palliative care. 

The Advice Line is answered by hospice nurses in the Inpatient Unit and queries are escalated to the on-call palliative medical team if needed.

24/7 Your Life Line 24/7 Hillingdon (YLL)
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The team is made up of clinical nurse specialists and health care assistants (HCA) who can support patients with complex needs at home in the last weeks and months of their life (with any diagnosis). 

The service is open 24 hours a day, 365 days a year, and can offer advice.

 Urgent night visits  are available to patients already referred to the service.

If you have already been referred to this service, you will have been given a direct contact number.

Speak to your GP or district nurse to be referred to the service.

Hillingdon Community Palliative Care Team
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Hillingdon Palliative Care Team (hosted by NHS CNWL) provides specialist advice and visiting to palliative care patients living in Hillingdon. Each GP practice has their own named Clinical Nurse Specialist ( CNS ). A Triage CNS manages calls and referrals each day and they have the option to escalate to consultants if needed.

They can be contacted Monday to Friday 8.00am to 4.30pm excluding bank holidays.

Out of hours phone Michael Sobell Hospice 24 hour Advice Line on 020 3824 1268

Referral form for clinician use only.

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

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