The decision to prescribe medicines ahead of time should always be based on a risk / benefit analysis.
Anticipatory prescribing for the most frequently occurring symptoms in the deteriorating and/or end-of-life phases:
- Prevents crises and unplanned admissions to hospitals; and
- Supports dying at home for those patients and their caregivers where this is their choice
Prior to prescribing, confirm and document:
- Exclusion of reversible / treatable causes, where appropriate
- Agreement from the team of the diagnosis of dying
- Discussion with the family
- Review of all current prescription.
If a patient is currently receiving subcutaneous analgesics, anxiolytics, antipsychotics or antiemetics; consider adding or increasing the doses of PRN medicines to manage emergent symptoms
All anticipatory orders should be reviewed after 24 hours