Palliative Sedation at the End of Life: Patterns of Use in an Israeli Hospice

Daniel Azoulay, Ruth Shahal-Gassner, Malka Yehezkel, Ester Eliyahu, Nir Weigert, Eliana Ein-Mor, Jeremy M. Jacobs

Research output: Contribution to journalArticlepeer-review

Abstract

Palliative sedation (PS) is indicated for refractory symptoms among dying patients. This retrospective descriptive study examines PS in an Israeli hospice. Palliative sedation was defined as PS to unconsciousness (PSU), PS proportionate to symptoms (proportional palliative sedation [PPS]), or intermittent PS (IPS). Among 179 patients who died during 2012, PS was used among 21.2% (n = 38): (PSU 34.2%, PPS 34.2%, and IPS 31.6%), using midazolam (n = 33/38), halidol (21/38), and concurrent morphine (n = 35/38). Indications included agitation (71%), pain (36.8%), and dyspnea (21%). Survival following initiation of PS was 73 ± standard deviation 54 hours. No differences in survival were observed according to who initiated the decision to use PS (patients/medical staff/family) or type of PS (PSU/PPS/IPS). Survival following PS was longest with higher sedative doses, an observation that may help dispel fears concerning the use of PS to hasten death.

Original languageAmerican English
Pages (from-to)369-373
Number of pages5
JournalAmerican Journal of Hospice and Palliative Medicine
Volume33
Issue number4
DOIs
StatePublished - 1 May 2016

Keywords

  • end-of-life care
  • hospice
  • palliative care
  • palliative sedation
  • survival
  • terminal sedation

All Science Journal Classification (ASJC) codes

  • General Medicine

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