title: Palliative sedation at home.
abstract: A large number of dying patients receive palliative care at home, and although palliative sedation (PS) may be indicated, literature describing PS at home is scarce. This study is a retrospective description of PS delivered to terminal patients at home from December 2000 to March 2006. A total of 36 patients (with a median age of 65) received home PS. Cancer was the diagnosis for 35 patients, and most patients suffered more than one symptom--most commonly, intractable pain, followed by agitation and existential suffering. Drugs used included midazolam, morphine, haloperidol, fentanyl TTS, and promethazine. Median duration of sedation was three days; median time to symptom control was 24 hours. Good symptom control was achieved in 28 out of 36 patients, and 34 of the patients died at home. In conclusion, PS was a feasible and successful treatment option, improving the care of terminal patients whose preference is to die at home.
authors.affiliation: Jerusalem Home Hospital Unit, Institute of Geriatric Medicine, Clalit Health Services, Jerusalem, Israel.
authors.forename: Ora S
authors.initials: OS
authors.lastname: Rosengarten
authors.forename: Yonat
authors.initials: Y
authors.lastname: Lamed
authors.forename: Timna
authors.initials: T
authors.lastname: Zisling
authors.forename: Ayelet
authors.initials: A
authors.lastname: Feigin
authors.forename: Jeremy M
authors.initials: JM
authors.lastname: Jacobs
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003258:Consumer Behavior; D005260:Female; D018718:Home Infusion Therapy; D017051:Hospice Care; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007557:Israel; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy; D009730:Nursing Assessment; D010166:Palliative Care
chemical_list: D006993:Hypnotics and Sedatives