What happens when someone who is dying can no longer swallow their medicines?

Australia · 1 September 2026 · 4 min read · Reviewed by Dr Kane Treble

When a dying person cannot swallow medicines, the care team can review what is still needed and use other routes for comfort medicines.

When a dying person cannot swallow medicines, the care team can review what is still needed and use other routes for comfort medicines. This is a common part of end-of-life care. It does not mean the person has been abandoned or that symptoms cannot be treated.

Some long-term tablets may be stopped because they no longer help in the time left. Medicines for pain, breathlessness, nausea, agitation, seizures or other distress can often be given another way.

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.

The team reviews each medicine

Near death, the aim of medicines often changes. The team may ask:

Is this medicine still helping comfort now?
Is it preventing a problem that is unlikely to matter in the time left?
Is it causing side effects or making swallowing harder?
Is there a safer route?
What matters most to the person and family?

This review should be individual. Do not assume every medicine should stop, and do not assume every medicine must continue.

Comfort medicines can often continue

If a medicine is needed for comfort, there may be another route. Depending on the medicine, the person and the setting, options may include:

injections under the skin
a syringe driver
liquid medicine if swallowing is still safe
wafers or dissolving tablets
patches
rectal medicine in selected cases.

A syringe driver is a small pump that gives medicine slowly under the skin. It can be useful when symptoms need steady treatment and swallowing is no longer safe.

What families should avoid

Do not crush tablets unless a pharmacist, nurse or doctor says that exact medicine can be crushed. Some tablets can be dangerous or ineffective if crushed.

Do not force tablets into the mouth of someone who is drowsy, unconscious, coughing or unable to swallow.

Do not hide medicine in food or drink if the person is refusing it. If they cannot make decisions, ask the team how decisions should be made under the care plan and the law in your state or territory.

Planning ahead helps

If someone is expected to die at home, ask about medicines before a crisis happens. Many palliative care teams arrange anticipatory medicines, which are medicines kept at home in case symptoms occur.

Ask who can give the medicines, when they can be used, and who to call after hours. In some plans, family carers may give certain medicines after training. In other plans, a nurse must visit.

Questions to ask

You can ask:

"Which medicines are still needed now?"
"Which can safely stop?"
"What route will be used if they cannot swallow?"
"Do we need a syringe driver?"
"Who can give breakthrough medicine?"
"What should we do overnight?"
"What symptoms should make us call urgently?"

When to get help now

Contact the palliative care team, GP, nurse or aged care staff urgently if the person cannot swallow medicines needed for pain, breathlessness, agitation, nausea, seizures or another distressing symptom.

Call 000 if there is choking, severe breathing difficulty, a seizure, collapse or another life-threatening emergency and there is no end-of-life plan telling you what to do.