Dear Barbara, Will you discuss palliative sedation?
Palliative sedation is a term used by hospice, palliative care, and medical professionals to describe giving large doses of sleep-inducing medications to induce unconsciousness. It is a pain management technique used when all other pain management options have been unsuccessful. It is not routinely used. I would even say it is seldom used.
The National Cancer Institute defines palliative sedation as: “The use of special drugs called sedatives to relieve extreme suffering by making a patient calm, unaware, or unconscious. This may be done for patients who have symptoms that cannot be controlled with other treatments. Palliative sedation may be used in patients who are near the end of life to make them more comfortable. It is not meant to shorten life or cause death.”
I found many other definitions (I love the internet), but this one was the easiest to understand and said what the others were saying but in much less technical detail.
When the terminal illness, the disease progression, has been a pain-filled experience and all comfort management options have been unsuccessful, then sleep is our friend. Sleep, created by regulated, supervised medications, is a compassionate alternative to uncontrollable suffering.
Covid taught us the benefit of “putting a person to sleep” as their body heals. That same technique can also be used as end of life approaches. Not to accelerate the end of life process, but to provide comfort until death comes.
Something More… about Using Palliative Sedation At End of Life
With today’s medical advancements there is no reason for a person to die in uncontrolled pain. If we are in extreme pain and suffering we cannot relax and peacefully leave our bodies. Reading Pain At End of Life helps families understand all the ways that a hospice team can ease pain with the dying.
17 comments
I am a hospice nurse, and I just want to thank you for your devotion to educating about end of life care and hospice. There are so many misperceptions about what hospice does for patients and their families. It’s very frustrating to read the negative comments here because it is evident that the patient being free of pain and at peace at end of life is not the goal of their families. It seems like many times those involved forget that the patient is our top priority. I will always advocate for my patient because they will always be my top priority!
My mother recently died at home on hospice care and we used palliative sedation towards the end but not because of pain. She was nauseated and getting more and more anxious about dying though she wasn’t agitated. One of the suggestions from the hospice nurse was regular doses of morphine to control the nausea and to let her sleep through the final steps of death. She was peaceful and calm listening to the birds outside her window when she died. The hospice folks are amazing!
———
BK Books replied:
Hi Mike, thank you for sharing your experience with your mom and hospice. There is comfort in knowing she died peacefully. Blessings! Barbara
Is palliative sedation an option for a home patient on hospice, and is there special monitoring that must be done beyond standard hospice RN assessments at end-of-life? I’ve recently been reading about palliative sedation and I’ve had a few patients who definitely could’ve benefited from it!
Side note…I purchased your series of booklets on Amazon Kindle…will your new booklet be available for those who have purchased all your other books as a series?
———
BK Books replied:
Hi Jen, yes, Palliative Sedation can be done in the home with hospice managing comfort levels. In regards to “special monitoring” my guess is it will depend upon the individual hospices policies and procedures. With Palliative Sedation there is no one dosage or procedure. Each person’s pain is different and requires different dosages. About will Always Offer, Never Force be available on Kindle—-we’re working on it. Blessings! Barbara
I have to agree with Traci Eaton above. I would not want this done on myself or a family member. Sounds like assisted suicide.
———
BK Books replied:
Hi Barbara, fortunately there is a choice in the care we receive. This is why having an Advanced DIrective is so important. I want to be clear it is not “assisted suicide”. Death is not the objective. Comfort, until death in its natural time arrives, is the goal. Blessings! Barbara
Hi Barbara. I purchased your set of books. I found them to be extremely helpful. I lost my Dad to sarcoma in 5/2020 & my dear Mama to rectal cancer in 10/2023. Both were in Hospice care & treated at the end with this sedative treatment. It broke my heart that we, the family, didn’t get a warning or a heads-up that NOW is the time (prior to pushing the drugs) to say your final sentiments as they will be unconscious from this point on. I was by their side the last few days. They essentially die from dehydration 😔 I understand the pain management side, but it was heartbreaking! Thanks for your commitment & concern.
———
BK Books replied:
Jennifer, I am sorry you did not receive the support and guidance before your parents were given medications. Part of hospice’s job is to educate families of what is happening, what to expect, and what to do while it is all happening—-in regards to any situation. They were remiss in their support of you. Blessings! Barbara
Leave a comment