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

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

  • Pain is a very common cause. Morphine (Opioid) medications are part of the core 'comfort pack' medications and should be used as directed if pain is present.

  • 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

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

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

  • Elevated temperature, concern for infection

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