[Treatment of restlessness in dying patients: more than just sedation]

Restlessness can make dying unnecessarily difficult, not only for the patient himself, but also for his family and the physician in charge. Four cancer patients, three men aged 69, 80 and 66 and a woman aged 88, displayed severe terminal restlessness, caused by nicotine abstinence, hypoglycaemia, constipation and urinary retention, respectively. Suitable interventions helped the patients to die in peace and dignity. Facing restless terminal patients the physician should think of withdrawal symptoms, metabolic derangements, full bladder and (or) rectum and intoxication by drugs, frequently morphine. Interventions directed at those problems may bring surprising results.