We all want our loved ones’ final days to be a peaceful and comforting experience. However, if your loved one is dealing with terminal agitation, these final days can be the exact opposite leading to stress and grief for everyone involved. It can be upsetting to watch your loved one suffer and when they are faced with this restless syndrome it can leave you feeling confused and heartbroken. At Hospice of South Louisiana, we know this type of agitation all too well but if you’re experiencing it for the first time with a loved one you may be left wondering what to do and how long terminal agitation will last before death.


What is Terminal Agitation?

Terminal agitation, also known as terminal delirium and terminal restlessness, is a syndrome that can occur in the final stages of life. Families often find themselves shocked when a terminally ill loved one suddenly becomes very agitated and restless. Mood and personality can seemingly change overnight leaving you bewildered and feeling helpless. Although terminal agitation varies in each person, there are common elements that have been seen over and over again. These common symptoms of terminal agitation include:

  • Hallucinations
  • Confusion
  • Anxious behavior, sometimes including aggression
  • Losing the ability to relax or concentrate
  • Trying to get out of bed throughout the night
  • Shouting or screaming
  • Constant fidgeting or twitching
  • Being tired during the day but active late into the night


While terminal agitation is most commonly linked to decreased brain function as the body’s organs begin to fail, there are other contributing factors that can make your loved one’s agitation more heightened. These factors include:

  • Medications: High or prolonged doses of opioids and anxiolytics can cause delirium in some patients. 
  • Pain: Uncontrolled pain can cause an increase in agitation during your loved one’s final days. 
  • Cancer treatments: Chemotherapy medications can be extremely rough on the body, especially for those that are terminally ill. These negative effects can cause severe restlessness. 
  • Fever: One of the most common side effects of high fever is delirium and agitation. 
  • Emotional distress: As the body is near death, many people can sense these final days which results in distress and anxiety leading to terminal agitation. 


As terminal agitation becomes more severe your loved one may complain about their lack of comfort, even if their pain is being managed. They may cry out in anger and frustration when they are usually calm and peaceful. If terminal agitation results in hallucinations and psychotic episodes, your loved one’s safety is jeopardized and it is time to consider hospice care to help them cope with the effects of this syndrome. 


So, How Long Does Terminal Agitation Actually Last?

The severity of terminal agitation can vary depending on the person. There is no one answer when it comes to how long terminal agitation lasts before death. Depending on the cause of terminal agitation, some causes can be treated quite easily and your loved one will be able to receive full comfort in their final days. In many cases, however, treatment can be challenging because it is difficult to identify just one root cause. If your loved one is suffering from terminal agitation it is important to receive professional care to help lessen the effects of their agitation as much as possible. By working with professional caregivers experienced in agitation, your loved one will have their pain and discomfort addressed to help them live more comfortable and peaceful moments in their final days. Depending on the cause of your loved one’s terminal agitation and the amount of caregiving involved, you can help give them the most comforting final days leading up to their passing. 


Coping with Terminal Agitation 

It’s important to know that no matter the effects terminal agitation has on a loved one’s emotions this does not reflect how they feel about you. Watching a loved one suffer from terminal agitation can cause family members and friends to feel guilty or at fault. Reassuring your loved one, talking to them in a gentle manner, and creating a safe and comforting environment are all steps that can be taken to help them cope with terminal agitation. Seeking professional assistance can provide relief in your loved one’s final days. Medication can often be used to provide comfort while in some cases a reversible cause can be identified. 


At Hospice of South Louisiana, we provide symptom management and quality care to make sure your loved one gets the most relief from terminal agitation. We provide constant patient assessments to help identify the cause so that we can develop a peaceful and serene end of life treatment. Contact us today so we can help provide comfort to you and your loved one. By working together we can help ease their distress and give your loved one the best quality of life possible.