What options exist if symptoms become intolerable despite treatment?
If symptoms feel intolerable, the first step is urgent specialist review because medicines, care plans, palliative sedation or VAD assessment may need to be discussed.
If symptoms become intolerable despite treatment, ask for urgent review by the palliative care team, treating specialist, GP or after-hours service. There may still be options for pain, breathlessness, agitation, nausea, fear or spiritual distress.
This is not a situation to manage alone.
General information: This page gives general information for people in Australia. It cannot tell what is right in one person's situation. If symptoms are severe or frightening, contact the treating team urgently or call 000 for a life-threatening emergency.
Ask for a full review
Symptoms can worsen because the illness has changed, but also because of infection, constipation, urinary retention, medicine side effects, anxiety, delirium or equipment problems.
The team may review medicines, routes of medicine, a syringe driver, oxygen or fan therapy, nursing support, equipment, counselling, spiritual care, or admission to hospital or hospice.
Palliative sedation may be discussed
For severe symptoms that cannot be relieved in other ways, palliative sedation may be considered. This uses sedating medicine to reduce awareness of suffering. It is not the same as VAD because the aim is symptom relief, not causing death.
VAD may or may not be an option
If VAD is legal where you live and you want information, you can ask. Eligibility is not automatic, and the process takes time. Palliative care should continue whether or not VAD is possible.
When to get help now
Call the palliative care team urgently for severe pain, breathlessness, agitation, panic, repeated vomiting, distress, bleeding or symptoms not controlled by the plan. Call 000 if there is immediate danger or a life-threatening emergency.
You may also want to read
- What is palliative sedation?
- What if I want VAD but do not qualify?
- What do we do tonight if they become breathless, agitated or in pain?