Question

What is the injection given at the end-of-life?

Answer 1

The injection that is given at the end of life is morphine for pain and breathlessness, lorazepam or midazolam for agitation and anxiety, and hyoscine for terminal secretions.

Hospice often gives these injections to dying patients to make the transition from life to death easier and painless.

Morphine or even alternatives like hydromorphone is used at the end of life to relieve severe pain and alleviate air hunger or shortness of breath and it also helps to calm the dying patients breathing.

Lorazepam or Ativan or Midazolam are sedatives that are used at end of life to treat severe anxiety, restless and terminal agitation.

Haldol also known as haloperidol is used at end of life for managing delirium, terminal agitation or nausea and vomiting and hyoscine butylbromide also known as Levsin or Scopolamine is used at end of life to dry up terminal secretions or the death rattle, which is the sound of saliva accumulating in the throat.

These injections are not given at the end of life to hasten death and instead when used appropriately, these injections are meant as comfort medications to manage symptoms and allow for a peaceful and comfortable passing on and not to cause death.

The two conditions that must be present for a patient to enroll in hospice are having a life expectancy of 6 months or less and having a terminal diagnosis.

For a patient to enroll in hospice, the patient must have a certified prognosis of a life expectancy of 6 months or less if the illness runs it's normal course and have a terminal diagnosis, with a documented decline in their health, in which the patient opts for palliative comfort care, instead of curative treatment.

For a patient to be eligible for hospice care, whether in a hospice center or at home, a doctor and a hospice medical director has to certify that the patient has an expected life expectancy of 6 months or less.

Although the hospice care can still be extended if the patient in hospice continues to meet the criteria.

There must also be documented and rapid decline in the patients status, like increased weakness, unintentional weight loss or frequent infections.

And the patient chooses to focus on quality of life and pain management, and forgoes further curative treatments.

A PPS or Palliative Performance Scale rating of <50% to 60% or needing assistance with daily living indicates that it's time for the patient to consider hospice.

Hospice can be provided in a hospice center or even in home through at home hospice, where a hospice nurse will visit the patients home.

Hospice care provides comprehensive comfort care (palliative care) for patients with a terminal illness (typically a life expectancy of six months or less) who choose to forgo curative treatments.

Hospice care focuses on pain management, quality of life, and emotional/spiritual support for patients and families, usually in the home, nursing home, or specialized facility.

Services of hospice care include routine home care, continuous home care (during crisis), inpatient care for symptom management and respite care to provide temporary relief to family caregivers.