Anticipatory medications

Anticipatory medicines.

What are they, what do they do and who are they for?

Anticipatory medicines are prescribed in advance to people who are receiving palliative care and approaching end of life.

Not everyone will be prescribed them and not everyone will need them (even if they have been prescribed them).

These medications will be kept at the home of the person who they have been prescribed for or within the facility they are being cared for so they are ready for immediate use.

Ok, so what are they for?

Anticipatory medicines are a way of ensuring a person has access to relief should they experience any distressing symptoms during any stage of their illness and, particularly, in the active stages of dying.

To reiterate – they are “just in case” medications. They may not be needed at all.

The most commonly prescribed anticipatory

medicines are:

Morphine – to help control pain and breathlessness.

Midazolam – to help control restlessness.

Levomepromazine / Haloperidol – to help control sickness.

Glycopyrronium – to help control secretions.

All are usually injectables or administered via a syringe driver by a medical professional.

Ultimately, they are put in place to help relieve suffering.

Some people find they are a comfort to have at hand.

Others are afraid and resistant.

There’s one thing I feel I need to make absolutely clear.

Anticipatory medications DO NOT hasten death.

So please try not to be afraid of them when they are offered.

What’s important to me, as a doula, is to have had these important discussions with the person and their family ahead of time, ahead of their intended use so they can make an informed decision and we are all absolutely clear on the person’s wishes regarding these medications. This can all be documented in an Advance Decision or, as it is sometimes known, ADRT.

I prefer not to assume, particularly regarding anxiety or agitation that medication is immediately required and that other avenues of physical. emotional, psychological and spiritual comfort have been explored first.

I have talked a little about secretions before (secretions don’t necessarily equate to suffering) but I will write a more specific post about this as it requires one all of it’s own.

However, if there is any doubt, the aim to minimise suffering for the person must take precedence.

I hope this is helpful.

Nancy xx

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