Pain management is an area that many people are concerned about towards the end of life if they have been diagnosed with an incurable illness. 'What if I’m in pain and won’t be able to bear it?' 'How can severe pain be held in check?' 'I’m so afraid of what might happen.'

Fortunately, one important aspect of palliative and end-of-life care is to aim to keep pain to a minimum, alongside providing medications and non-medicine related options for sickness, confusion, nausea and other symptoms.

Taking medication can take a lot of effort and can cause side effects, so the possible benefits of each medicine need to be carefully considered. When you are approaching the end of your life, you may have difficulty taking medication by mouth. You might also be very sleepy or lose the ability to swallow.

The palliative care team will give this careful thought when they review your medications and stop any that are no longer of any benefit. Even medicines that have been taken for many years and have always been important may be stopped.

Medication used to help with comfort at the end of life may be given by injection or infusion. These are given through a small needle into the soft tissue under the skin.

If you are likely to need repeated injections, a syringe driver might be used. This is a small battery-operated pump that delivers medication at a continuous, steady rate. Giving medication in this way can be more comfortable than repeated injections and can also help to avoid difficulties with symptom control.

Medication often needed at the end of life

• Painkillers (used for pain and sometimes shortness of breath and cough).
• Anti-sickness medication (used for nausea, vomiting or hiccups).
• Relaxants (for restlessness, anxiety or to help with sleep).
• Anti-delirium medication (for hallucinations or distressed confusion).
• Medicines to reduce secretions (for noisy, rattly breathing sounds).

Related pages

• Your needs as a carer: the role of a carer can be very challenging, but there's help out there for you, both financially and to support your mental health.
• Who provides palliative care?: a detailed look at the different care teams and support services for palliative care at home, in a hospice or elsewhere.
• What is end-of-life care?: read more about what care is provided in the last months, weeks and days of your illness with a focus on managing symptoms.

The EPiC Resource Centre is kindly sponsored by Cleenol: working for a cleaner, safer, kinder world.