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American Journal of Hospice and Palliative Medicine®
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Palliative Sedation in a Southern Appalachian Community

John D. Cowan, MD

Palliative Care and Hospice, Advanced Illness Assistance Team, Blount Memorial Hospital, Maryville, Tennessee, jcowan{at}bmnet.com

Libby Clemens, APN

Palliative Care and Hospice, Advanced Illness Assistance Team, Blount Memorial Hospital, Maryville, Tennessee

Teresa Palmer, APN

Palliative Care and Hospice, Advanced Illness Assistance Team, Blount Memorial Hospital, Maryville, Tennessee

Of 1200 palliative care patients, 28 received palliative sedation. They were more likely than patients without palliative sedation to have an Eastern Cooperative Oncology Group performance status of at least 3, a cancer diagnosis, an expected survival of weeks or less, to have been monitored by the palliative care team for at least 1 week, to have delirium as the cause of decreased communication, to have dyspnea as a non-pain symptom, and to be less able to communicate symptoms. Almost 90% received palliative sedation for at least 24 hours for a median of 3 days (range, 0 to 24 days). Home patients received palliative sedation longer. Symptoms were controlled in 82% and improved in the rest. Sedation developed in 79% but was not required for symptom control in 5. Patient survival from palliative care consultation was a median of 8 days (range, 0 to 32 days).

Key Words: palliative sedation • refractory symptoms • community palliative care

American Journal of Hospice and Palliative Medicine®, Vol. 23, No. 5, 360-368 (2006)
DOI: 10.1177/1049909106292173
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