Anxiety/Restlessness

This is a very common symptom and should be expected to occur at some point, especially in the last weeks/days of life.

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Possible Causes

Dehydration

Shortness of breath

Side effects from medications

Pain

Constipation, Urinary retention. Especially in patients with Dementia

Infections: agitation likely, especially if fever is present. Urinary tract infections are very common

Lack of sleep

Psychological issues: increasing fear of death, unresolved conflicts, and depression can also present as anxiety

What to do first

  • Ask about pain

  • Check if seems more short of breath

  • Ask about any new physical symptoms

  • Take their temperature

  • Ask about the last bowel movement, check for decreased urination

  • Review medications with the Hospice team

  • If you are comfortable asking - "Is there something bothering you that you want to talk about"

Medications/Strategies

  • Medications are available to reduce anxiety and agitation when needed

  • Lorazepam is one of the core 'comfort pack' medications you received on day of admission to hospice. Its purpose is to relieve anxiety and can be used as directed.
    Other medications for agitation that the hospice team that may have provided are: Haldol, Seroquel (Quetiapine)

  • Pain is a common cause of restlessness. If pain is present, opioid medications may help improve comfort

  • If you think there are issues that need to be discussed and are uncomfortable, the Hospice Team has professionals who are trained to discuss emotionally difficult topics.

When to Call the Hospice

  • Sudden confusion, agitation, or restlessness may be part of a condition called delirium, which is common in serious illness.

  • Anxiety is increasing, not relieved with the lorazepam or pain medications

  • New fever develops

  • You think that one of the problems listed above is causing the problem and need help treating

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