Do I need to keep turning someone if moving them causes pain?
If turning causes pain near the end of life, ask the care team to adjust the plan so comfort comes first.
If turning causes pain near the end of life, ask the care team to adjust the plan so comfort comes first. You should not keep forcing full turns if they clearly distress the person.
Skin care still matters, but the plan may need to change. Smaller position changes, better equipment, pain medicine timing, or fewer turns may be more humane.
General information: This page gives general information for people in Australia. It cannot tell you exactly what is happening in one person's situation. If you have concerns about a symptom, medicine, treatment decision or change in someone's condition, contact their doctor, palliative care team, nurse or other treating health professional.
Why this decision changes near death
Earlier in an illness, regular turning may be used to reduce pressure injuries. In the last days or hours, a person may be more fragile, breathless or sore. Movement can cause more harm than benefit if it triggers severe pain or distress.
The care goal is comfort and dignity. That may mean changing how skin care is done.
What to try
Ask the nurse or palliative care team about:
- smaller tilts instead of full side turns
- pillows under one hip or shoulder
- protecting heels
- a pressure-relieving mattress
- a slide sheet or extra helper
- timing movement after prescribed pain medicine
- combining care tasks so the person is moved less often.
Do not change medicine doses without advice.
How to judge distress
Stop and ask for help if the person grimaces, cries out, moans, stiffens, becomes breathless, panics, pushes you away, or remains unsettled after turning.
If the person cannot speak, their face, breathing and body can still show discomfort.
Skin care without rough movement
You may still be able to keep the person clean and dry, smooth wrinkles, use absorbent pads, apply barrier cream if advised, and protect bony areas with pillows.
Do not rub fragile skin hard. Report redness, blisters, broken skin, bleeding, swelling, bad smell or increasing pain.
When to get help now
Contact the palliative care team, GP, nurse or aged care staff if movement causes pain, breathlessness, agitation, skin damage, or if you cannot provide care safely.
Call 000 if there is a fall, serious injury or sudden life-threatening emergency and no end-of-life plan telling you what to do.
You may also want to read
- How often should I turn someone who is dying in bed?
- How do I change sheets when someone cannot get out of bed?
- How do I prevent pressure sores when someone is dying?
- Is what I'm seeing normal dying, or are they suffering?