What are terminal secretions?
Sounds made near the time of death as a result of fluid collecting in the throat and/or chest. Not all hospice patients develop terminal secretions however, it is best to know how to manage them if they do occur.
Your loved one is NOT in any discomfort, suffering, suffocating, or uncomfortable when experiencing terminal secretions.
What causes terminal secretions?
A build-up of fluid and mucus in the throat and airways
Decreased airway flow caused by inflammation or edema
Increased shallow breathing Decreased ability to cough or swallow
What to do when the secretions start?
Non - Medication Options
Non-medication treatments are the most effective and without the unnecessary side effects that come with medications.
Repositioning: Elevate head/upper body
Repositioning: Rotate from one side to the other
Regularly keep the mouth clean and dry (suctioning is not helpful)
Avoid forcing fluids even if your loved one "looks thirsty"
Start medications as soon as possible for maximum effectiveness. Medications PREVENT the build-up of secretions, they do not remove secretions already there.
Side effects include agitation, anxiety, increased heart rate, palpitations, dry mouth, flushing, drowsiness, headache
Medications are given by mouth, by injection, and by patches Patches may take up to 12 hours to work
Medications include Atropine, Hyoscyamine, Scopolamine, and Glycopyrrolate
Things to Remember
Your loved one is NOT distressed, choking, or uncomfortable.
Management of terminal secretion is primarily to decrease the distress of loved ones
When deciding to use medications remember to weigh risks versus benefits
Terminal secretions last only 24-48 hours