Why does a dying person sometimes have a fever?
Fever near the end of life can come from infection, inflammation, medicines or the body's changing temperature control.
Fever near the end of life can come from infection, inflammation, medicines or the body's changing temperature control. Sometimes it is part of the final illness. Sometimes it points to a problem that may be treated if treatment fits the person's goals of care.
Ask the care team to assess a new or worrying fever, especially if the person seems distressed, hot, sweaty, shivery, confused or uncomfortable.
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 fever can happen
A person near the end of life may be more vulnerable to infections such as pneumonia, urinary infection or infected wounds. Advanced cancer, organ failure or inflammation can also cause fever. Some medicines can affect temperature.
As the body shuts down, temperature control can become less steady. A person may feel hot at times and cold at other times.
Does fever need antibiotics?
It depends. Antibiotics may help some infections and may improve comfort for some people. In other situations, antibiotics may not help much, may cause side effects, or may not fit the person's goals.
This is a decision to discuss with the treating doctor or palliative care team. It should take into account the likely cause, the person's stage of illness, their wishes, their advance care plan if they have one, and whether treatment is likely to improve comfort.
Comfort measures
Ask the team what is safe. Comfort measures may include:
- removing excess blankets
- using light clothing or sheets
- keeping the room comfortable
- offering mouth care
- using a cool cloth if the person likes it
- giving medicine for fever if prescribed or advised.
Do not give over-the-counter medicines unless the team says they are safe for that person. Some medicines may be unsafe with kidney disease, liver disease, bleeding risk, swallowing problems or other medicines.
When fever may cause distress
Tell the team if the person is shivering, sweating heavily, grimacing, breathing harder, becoming more confused, very restless, or unable to settle. Fever can worsen delirium, dehydration, weakness and discomfort.
The team may check for pain, infection, urinary retention, constipation, medicine effects or other causes.
Questions to ask
You can ask:
- "What might be causing the fever?"
- "Would treating it improve comfort?"
- "Are antibiotics likely to help?"
- "What fever medicine is safe?"
- "What should we do if it happens overnight?"
When to get help now
Contact the palliative care team, GP, nurse or aged care staff urgently if fever is new, high, causing distress, or comes with severe breathlessness, confusion, pain, seizure, shaking chills, a fall, or reduced consciousness that is not expected.
Call 000 if there is a sudden life-threatening emergency and no end-of-life plan telling you what to do.
You may also want to read
- Is what I'm seeing normal dying, or are they suffering?
- Can I refuse antibiotics, hospital transfer, tube feeding or other treatment in advance?
- What do I do if something frightening happens at 2 am?
- When should I call the palliative care team?