Care of dying adults in the last days of life

Stopping medicines that aren't needed

Often people are taking medicines to treat the conditions they have. When they reach the last days of their life, they might not need to keep taking them all, especially if the medicine isn't helping them to stay comfortable. Their doctor should talk with them about which medicines they might stop taking that may no longer be helpful.

Using new medicines

Before starting a new medicine, a doctor should check for any problems that might be caused by taking the medicine at the same time as other treatments or for distressing side effects the medicine might cause. The doctor will discuss the benefits and any side effects of the medicine, including whether some side effects might or might not be acceptable, for example, increased drowsiness caused by medicine for pain or nausea and vomiting might not be a problem for some people but might be unacceptable for others. They should also take into account whether the person has any cultural or personal preferences that might affect the choice of medicine.

Once the medicine is started, checks should be carried out at least once a day to see if the symptoms are improving, to make sure the right amount of medicine is being given and to check for any side effects, such as a dry mouth or unwanted drowsiness. If symptoms don't improve quickly or there are unwanted side effects, a member of the care team should get advice from a doctor who specialises in caring for people in the last days of their life.

Deciding how medicine should be given

Medicines should be given in the most comfortable way possible. This can depend on the person's condition, if they can swallow or are being sick, and how they would prefer to take their medicine. They may need to have a patch on the skin or be given their medicine by injection if they can't swallow. A syringe pump (for continuous use) might be used when medicines are needed several times a day.