ABSTRACT
Pharmacological therapy and psychological intervention to minimise the distress of the patient and relatives are the mainstay of treatment for terminal restlessness. Terminal restlessness overlaps with but is not necessarily identical to delirium. Terminal restlessness is distressing for the patient and family, and it can be mismanaged through fear of oversedation. Intramuscular injections are painful for thin, frail patients, and should be avoided. Reassure the family that time set aside for them is important and that it is acceptable to take that time. Using supportive complementary therapies, and attending a support group, may be appropriate. Terminal restlessness and agitation, with or without delirium, is a frightening experience. It represents a challenge. Ongoing assessment and evaluation is central to achieving effective outcomes. Preparing the family for the possible occurrence of restlessness and agitation may be a possibility. Reassurance that, in most cases, something can be done will help to reduce some of the inevitable anxieties, and is essential.
