Recognising dying and providing symptom control, communication and support in the final days.
Management
- • Review and stop non-essential medication and observations
- • Anticipatory subcutaneous prescribing: morphine (pain/dyspnoea), midazolam (agitation), haloperidol or levomepromazine (nausea), hyoscine butylbromide (secretions)
- • Mouth care hourly and skin protection
- • Individualised hydration decision reviewed daily
- • Discuss and document DNACPR, preferred place of death and spiritual needs
Clinical pearls
- • Syringe driver conversion: oral morphine ÷ 2 = 24 h subcutaneous morphine dose
- • Family need explicit explanation that reduced intake is part of dying, not the cause
Related in WardRound
Educational — verify locally.
