Morphine is an opiate, a strong drug used to treat serious pain. Sometimes, morphine is also given to ease the feeling of shortness of breath. Successfully reducing pain and addressing concerns about breathing can provide needed comfort to someone who is close to dying.
The most commonly prescribed drugs include acetaminophen, haloperidol, lorazepam, morphine, and prochlorperazine, and atropine typically found in an emergency kit when a patient is admitted into a hospice facility.
Comfort care often implies that the person is reducing the intensity of medical care because the burden is outweighing the benefits. It also commonly means the individual recognizes that they are nearing the end of their life.
Terminally ill cancer patients near the end of life can experience refractory symptoms, which require palliative sedation. Midazolam is the most common benzodiazepine used for palliative sedation therapy.
Palliative sedation is a measure of last resort used at the end of life to relieve severe and refractory symptoms. It is performed by the administration of sedative medications in monitored settings and is aimed at inducing a state of decreased awareness or absent awareness (unconsciousness).
Midazolam is a commonly used benzodiazepine in palliative care and is considered one of the four essential drugs needed for the promotion of quality care in dying patients. Acting on the benzodiazepine receptor, it promotes the action of gamma-aminobutyric acid.
Comfort care is often used interchangeably with palliative care or hospice. All three terms refer to care that improves the quality of life by relieving suffering and providing practical, emotional, and spiritual support.
Visions and Hallucinations
Visual or auditory hallucinations are often part of the dying experience. The appearance of family members or loved ones who have died is common. These visions are considered normal. The dying may turn their focus to “another world” and talk to people or see things that others do not see.
As the moment of death comes nearer, the person's breathing may slow down and become irregular. It might stop and then start again or there might be long pauses or stops between breaths. This is sometimes known as Cheyne-Stokes breathing.
A bystander hands a medicine bottle to the attending paramedic frantically saying, “They drank this! They drank this!” The bottle contains digoxin 100 mg, diazepam 1,000 mg, morphine 15,000 mg, amitriptyline 8,000 mg and phenobarbital 5,000 mg.
End of life care is support for people who are in the last months or years of their life. End of life care should help you to live as well as possible until you die and to die with dignity.
Made from morphine or diacetylmorphine (heroin), cocaine, highly-pure ethyl alcohol (some recipes specify gin), and sometimes with chlorpromazine (Thorazine) to counteract nausea, it was given to terminally-ill individuals (especially cancer patients) to relieve pain and promote sociability near death.
Terminal agitation is typically seen during the hours or days before death and can be distressing and overwhelming for caregivers.
Terminal sedation was defined as the administration of drugs to keep the patient in deep sedation or coma until death, without giving artificial nutrition or hydration.
What are the signs that death is near? Someone who is very close to death will likely refuse food and water. Their breathing and heart rates will slow and/or be abnormal and their hands, arms, feet, or legs may be cool to the touch. They may also be agitated, anxious, and confused.
Hospice has a program that says that no one should have to die alone, and yet this hospice nurse is telling me to take a break? Some patients want to die when no one else is there. Hospice professionals know that companionship while dying is a personal preference.
In time, the heart stops and they stop breathing. Within a few minutes, their brain stops functioning entirely and their skin starts to cool. At this point, they have died.
Morphine and Respiratory Distress
For hospice patients who have trouble breathing, small amounts of well-controlled and regularly titrated morphine can help ease respiratory distress by decreasing fluid in the lungs and altering how the brain responds to pain.
Although it can include end of life care, palliative care is much broader and can last for longer. Having palliative care doesn't necessarily mean that you're likely to die soon – some people have palliative care for years. End of life care offers treatment and support for people who are near the end of their life.
The benefits of hospice care, from increased comfort therapies, to services such as Crossroads' Gift of a Day, can help the patient for as long as six months. If you or your loved one is terminal, there is no reason not to start making life better right now.
Notably, the drug midazolam increased most pain perceptions evoked by experimental stimuli, whereas the drugs propofol and dexmedetomidine produced analgesia in many of the same pain modalities.
What Does Hospice Care Not Include? Hospice care does not include curative treatment. The goal of hospice care is to provide comfort and support rather than to cure the disease. Hospice may not include medications you have grown accustomed to taking, such as chemotherapy or other medical supplements.
Nursing and other medical staff usually talk to sedated people and tell them what is happening as they may be able to hear even if they can't respond. Some people had only vague memories whilst under sedation. They'd heard voices but couldn't remember the conversations or the people involved.