The last few days

Abstract

In the dying patient, coma is preceded by either progressive sedation or the development of the organic brain syndrome of delirium. More than one-third of dying patients experience some difficulties during the last 48 hours of life with noisy and moist breathing, pain, and agitation and restlessness the most common. The great majority of these terminal symptoms can be managed by reassurance or drug intervention. Sublingual lorazepam and continuous subcutaneous infusion of midazolam can be effective in controlling terminal restlessness.