Suffering and Palliative Sedation at the End of Life
Key Points for This Section
The emotions of patients and caregivers are closely connected.
Patients and caregivers share the distress of cancer, with the caregiver's distress sometimes being greater than the patient's. Since caregiver suffering can affect the patient's well-being and the caregiver's adjustment to loss, early and constant support of the caregiver is very important.
Palliative sedation lowers the level of consciousness and relieves extreme pain and suffering.
The decision whether to sedate a patient at the end of life is a hard one. Sedation may be considered for a patient's comfort or for a physical condition such as uncontrolled pain. Palliative sedation may be temporary. A patient's thoughts and feelings about end-of-life sedation may depend greatly on his or her own culture and beliefs. Some patients who become anxious facing the end of life may want to be sedated. Other patients may wish to have no procedures, including sedation, just before death.
Studies have not shown that palliative sedation shortens life when used in the last days.
It is important for the patient to tell family members and healthcare providers of his or her wishes about sedation at the end of life. When patients make their wishes about sedation known ahead of time, doctors and family members can be sure they are doing what the patient would want. Families may need support from the healthcare team and mental health counselors while palliative sedation is used.