As an experienced , I have seen many patients at the end of their lives. It is crucial to understand that the dying process is a natural part of life, and it is our responsibility to make it as comfortable and dignified as possible. Below are some common end-of-life symptoms that you may encounter and some tips on how to manage them effectively.


Pain is one of the most common symptoms experienced by people at the end of their lives. It is essential to address pain immediately and consistently throughout the hospice journey. Some tips to manage pain include:

  • Identify the source and nature of the pain
  • Use the right pain medication based on the pain's intensity and type
  • Administer medications regularly and as prescribed
  • Adjust the medication dosage based on the patient's response
  • Use complementary therapies such as music therapy, massage, and relaxation techniques to supplement pain medications.

Some commonly used pain medications include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen
  • Acetaminophen (Tylenol)
  • Opioids such as morphine or fentanyl.

Shortness of Breath and Respiratory Distress

and respiratory distress can be challenging for the patient and their family. The following tips can help manage these symptoms:

  • Sit the patient upright to make breathing easier
  • Use a small fan on the lowest setting pointing towards the patient's right or left cheek
  • Teach the patient how to use pursed lip breathing
  • Use to provide relief if applicable
  • Administer bronchodilators to relax the airways
  • Consider morphine or other opioids to reduce respiratory distress.
  • Consider Lorazepam if the patient is hyperventilating as part of the or the shortness of breath is driven


is a common symptom experienced by people at the end of their lives. It can stem from many sources, including fear of dying, pain, or changes in their physical and mental state. To help manage anxiety, try the following:

  • Identify the source of anxiety and address it directly
  • Use relaxation techniques such as deep breathing or meditation
  • Administer anti-anxiety medications such as lorazepam or diazepam
  • Encourage the patient to express their fears and concerns and provide emotional support.

Terminal Restlessness and Terminal Agitation

and terminal are common in the final days or hours of a patient's life. The following tips can help manage these symptoms:

  • Identify the underlying cause, such as pain or anxiety, and address it appropriately
  • Use medications such as haloperidol or lorazepam to manage and
  • Provide a calm and peaceful environment
  • Offer emotional and spiritual support to the patient and their family.

Non-Pharmacological Treatments

Non-pharmacological treatments can be used alone or in conjunction with medications to manage end-of-life symptoms. Some non-pharmacological treatments that can help include:

  • Music therapy
  • Art therapy
  • Pet therapy
  • Massage therapy
  • Relaxation techniques
  • Spiritual support and counseling
  • Validation Therapy


Managing end-of-life symptoms requires a holistic approach that considers both the patient's physical and emotional needs. As a , it is crucial to identify and address symptoms promptly, provide comfort and dignity to the patient, and support their family throughout the hospice journey. Remember, is about making the patient's final days as comfortable and peaceful as possible.


Guide to the Pharmacological Management of End of Life (Terminal) Symptoms in Residential Aged Care Residents

The Importance of Caregiver Journaling

Reporting Changes in Condition to Hospice

Eldercare Locator: a nationwide service that connects older Americans and their caregivers with trustworthy local support resources

Surviving Caregiving with Dignity, Love, and Kindness | Simplifying the Search for In-Home Care

As an Amazon Associate, I earn from qualifying purchases. The amount generated from these “qualifying purchases” helps to maintain this site.

My Aging Parent Needs Help!: 7-Step Guide to Caregiving with No Regrets, More Compassion, and Going from Overwhelmed to Organized [Includes Tips for Caregiver Burnout]

Take Back Your Life: A Caregiver's Guide to Finding Freedom in the Midst of Overwhelm

The Conscious Caregiver: A Mindful Approach to Caring for Your Loved One Without Losing Yourself

Dear Caregiver, It's Your Life Too: 71 Self-Care Tips To Manage Stress, Avoid Burnout, And Find Joy Again While Caring For A Loved One

Everything Happens for a Reason: And Other Lies I've Loved

The Art of Dying

Final Gifts: Understanding the Special Awareness, Needs, and Communications of the Dying

Pain Assessment in Hospitalized Older Adults With Dementia and Delirium

Pain Assessment in Dementia – International Association for the Study of Pain (IASP)

Pain Assessment in People with Dementia: AJN The American Journal of Nursing

PAINAD Scale Offers Alternative to Assessing Pain in the Dementia Patient – JEMS: EMS, Emergency Medical Services – Training, Paramedic, EMT News

Pain Assessment in Advanced Dementia Scale (PAINAD) – MDCalc

Uncontrolled Pain and Risk for Depression and Behavioral Symptoms in Residents With Dementia

Chronic Pain & Symptom Tracker: A 90-Day Guided Journal: Detailed Daily Pain Assessment Diary, Mood Tracker & Medication Log for Chronic Illness Management

Pain And Symptom Tracker: Daily Pain Tracking Journal Detailed Pain Assessment Diary, Medication, Supplements Food & Activities Log for Chronic Illness Management

Pain Assessment and Pharmacologic Management

Adult Nonverbal Pain Scale (NVPS) Tool for pain assessment

Assessing pain in patients with cognitive impairment in acute care

FLACC Pain Scale

Pain Assessment in Advanced Dementia Scale (PAINAD)

Pain Assessment in Non-Communicative Adult Palliative Care Patients

Pain Assessment in People with Dementia

Tools for Assessment of Pain in Nonverbal Older Adults with Dementia: A State-of-the-Science Review

Understanding the physiological effects of unrelieved pain

Untreated Pain, Narcotics Regulation, and Global Health Ideologies

Providing Comfort During the Last Days of Life with Barbara Karnes RN (YouTube Video)

Preparing the patient, family, and caregivers for a “Good Death.”

Velocity of Changes in Condition as an Indicator of Approaching Death (often helpful to answer how soon? or when?)

The Dying Process and the End of Life

The Last Hours of Life

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Gone from My Sight: The Dying Experience

The Eleventh Hour: A Caring Guideline for the Hours to Minutes Before Death

By Your Side, A Guide for Caring for the Dying at Home

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