“Are people sedated in end-of-life care?”
When people are in hospice or palliative care are they typically sedated? Would they feel anything pain-wise?
6 Answers
No necessary
They feel no pain
Usually people in hospice or palliative care are given medication to minimize any pain or anxiety that they might experience. However, it is also important for them to be able to interact with family and staff as fully as possible; so any medications are given conservatively at first, to determine how the patient reacts to them.
This is an excellent question and depends on many factors, as to the wishes of the patient, facility, family, etc. Many patients, depending on the situation, may be on pain medication which in itself has a side effect of sedation, but many may have wishes for as-needed sedation. An example may be a patient who has lung cancer and has "air hunger" or shortness of breath, which leaves them feeling anxious despite oxygen. In those cases, an IV drip of a sedative agent which can be turned up or down to keep the patient comfortable, but still interactive can be excellent.
There are many strategies than can be implemented, often Hospice or Pallative care physicians may feel comfortable recommending the proper combination of medications. If in doubt, ask for an anesthesia consult in addition, as often anesthesiologists are experts at reducing pain and maintaining sedation at a proper level to allow for patient comfort, but
can be easily woken. These medications often have reversal agents should there be an imbalance causing over sedation.
The best advice I can give family members and patients is to meet with their family and physicians before filling out power of health care living will or advance care directives. If done with pallative or hospice doctors and staff, and including anesthesiologists if needed, the type of sedation and or pain relief can be discussed and implemented before it is needed.
There are many strategies than can be implemented, often Hospice or Pallative care physicians may feel comfortable recommending the proper combination of medications. If in doubt, ask for an anesthesia consult in addition, as often anesthesiologists are experts at reducing pain and maintaining sedation at a proper level to allow for patient comfort, but
can be easily woken. These medications often have reversal agents should there be an imbalance causing over sedation.
The best advice I can give family members and patients is to meet with their family and physicians before filling out power of health care living will or advance care directives. If done with pallative or hospice doctors and staff, and including anesthesiologists if needed, the type of sedation and or pain relief can be discussed and implemented before it is needed.
Ideally, a patient can be pain free without being sedated. If the pain regimen is appropriate it can often give adequate pain relief without significant sedation. It all depends on the pain tolerance of the patient and the severity of the pain.
If they get opiates for pain, there is a sedative component to those medicines. Otherwise, no.
